/ CONFIDENTIAL
Supplier Evaluation: IMP Packaging
Quality Questionnaire
Page 1 of 11

INSTRUCTIONS

  1. Please complete this questionnaire electronically.
  2. Use the  and  keys or your mouse to navigate around the form
  3. Click the grey-shaded fields to enter the required information.
  4. Click the grey-shaded boxes to check  or uncheck .
  5. Print the completed form, then sign and date.
  6. Return to DNDi along with copies of any supporting information. These may be sent electronically as PDF files for convenience.

1. SUPPLIER INFORMATION
1.1 / Supplier name:
1.2 / Corporate address:
1.3 / Address of packaging premises:
1.4 / Types of packaging operations performed (e.g., labelling only; filling of bottles, blisters, ampoules, sachets, syringes):
1.5 / Dosage forms packaged (e.g., liquids, tablets, sprinkles, gels, creams, capsules):
1.6 / Capability to supply tamper-evident packaging:
2. GENERAL INFORMATION
2.1 / What types of materials do you package, manufacture or handle at the premises?
Pharmaceuticals? / Yes / No
Agricultural chemicals? / Yes / No
General chemicals? / Yes / No
Food ingredients? / Yes / No
Other (please specify):
2.2 / Do you follow current Good Manufacturing Practices (cGMP) at the premises? / Yes / No
If Yes, please list which cGMP standards you follow:
2.3 / Are the premises inspected by national or international health authorities? / Yes / No
If Yes, please list health authority, date of inspection and outcomes:
2.4 / Are the premises subject to any regulatory warning or enforcement actions? / Yes / No
If Yes, please describe these below:
2.5 / Please list any additional quality accreditations (e.g. ISO 9001):
PLEASE PROVIDE COPIES OF SUPPORTING DOCUMENTATION, CERTIFICATES ETC.
3. PERSONNEL
3.1 / Do you have written job descriptions for all personnel? / Yes / No
3.2 / Do you have a written training policy or procedure? / Yes / No
3.3 / Do you maintain training records for all staff? / Yes / No
3.4 / Does the training program include:
cGMP regulations and updates? / Yes / No
Quality systems? / Yes / No
Continuous improvement techniques? / Yes / No
Job specific training? / Yes / No
Periodic refresher training? / Yes / No
Hygiene? / Yes / No
Cleanliness? / Yes / No
Health and safety? / Yes / No
3.5 / Please describe how the competency of staff is evaluated:
If you answered No to any of the questions above, pleaseuse the space below to provide additional information:
4. PREMISES, UTILITIES AND EQUIPMENT
4.1 / Were the premises designed for their present use? / Yes / No
4.2 / Are there separate areas for:
Receipt of bulk packaging components and materials? / Yes / No
Preparation and control of labelling materials? / Yes / No
Packaging? / Yes / No
Quarantined finished goods? / Yes / No
Approved finished goods? / Yes / No
Rest and eating? / Yes / No
4.3 / Does the present design prevent:
Chemical contamination? / Yes / No
Physical contamination? / Yes / No
Microbial contamination? / Yes / No
4.4 / Are any of the following materials packaged or manufactured in the premises:
Beta-lactams (cephalosporins, penicillins)? / Yes / No
Hormones? / Yes / No
Cytotoxic, genotoxic? / Yes / No
Pesticides, herbicides? / Yes / No
Biological or GMO preparations? / Yes / No
Highly potent/toxic products? / Yes / No
If you answered Yes to any of the above, please describe specific measures taken to prevent crosscontamination:
4.5 / Do your areas for packaging, testing and storage have:
Written cleaning or house-keeping procedures? / Yes / No
Environmental controls and monitoring program
(e.g. temperature, humidity, microbial)? / Yes / No
A pest control program? / Yes / No
Security/access control measures? / Yes / No
If you answered Yes to any of the above, are records for these available? / Yes / No
4.6 / Has full qualification (IQ, OQ, PQ) of all utilities (e.g., HVAC, purified water, WFI, compressed air, clean steam) that support packaging operations, including equipment cleaning, been completed and documented? / Yes / No
4.7 / Do you monitor the conformance of all utilities to their quality standards? / Yes / No
4.8 / Are plant utilities pipelines clearly identified and labelled? / Yes / No
4.9 / Is there a maintenance/preventative maintenance program for all equipment? / Yes / No
4.10 / Do you have written maintenance and calibration procedures for critical equipment? / Yes / No
4.11 / Is there a written cleaning plan/procedure for all equipment? / Yes / No
4.12 / Have the cleaning procedures been validated? / Yes / No
4.13 / Is any packaging equipment software-controlled? / Yes / No
If Yes, is this software:
Validated? / Yes / No
Subject to change control procedures? / Yes / No
If you answered No to any of the questions above, please provide the space below to provide additional information:
5.BULK PACKAGING COMPONENTS AND MATERIALS
5.1 / Are incoming bulk packaging materials inspected, sampled and tested according to written procedures? / Yes / No
5.2 / Do you have written specifications for all incoming packaging materials, including cleaning agents for packaging equipment and premises? / Yes / No
5.3 / Do you routinely test incoming packaging materials to verify conformance with the supplier certification or quality claims? / Yes / No
5.4 / Are suspect or rejected materials identified and controlled under a quarantine system designed to prevent their use until a final decision is made on their suitability? / Yes / No
5.5 / Do you have an established supplier qualification program? / Yes / No
5.6 / Are storage conditions and expiry dates defined for all packaging materials? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
6 .PACKAGING SET-UP
6.1 / Do you package each batch according to pre-approved packagingprocedures/instructions? / Yes / No
6.2 / Does each batch packaging record contain complete details of:
Description, batch numbers and quantities of materials used? / Yes / No
Samples of labelling used? / Yes / No
Date of packaging? / Yes / No
Equipment used? / Yes / No
Equipment settings? / Yes / No
Names of operators? / Yes / No
Details and results of in-process tests? / Yes / No
Deviations and changes that have occurred? / Yes / No
Cleaning operations performed before and after packaging? / Yes / No
6.3 / Who reviews and approves these records after manufacture?
6.4 / How long do you keep these records?
6.5 / Is only one product batch and packaging size on a line at any given time? / Yes / No
6.6 / Are all deliveries of bulk product and packaging components checked and verified for their correctness against the Master Packaging Procedure or other specific order? / Yes / No
6.7 / Does pre-coding of components take place in an area isolated from other packaging operations? / Yes / No
6.8 / Are components allocated for pre-coding stored in sealed containers within an appropriate area for proper security and segregation? / Yes / No
6.9 / Are all pre-coded components checked against the correctness before transfer to the packaging line? / Yes / No
6.10 / Before a packaging operation starts in a work area or on a packaging line is an inspection conducted to ensure:
General cleanliness of the line and the immediate area? / Yes / No
Removal of all previous drug product, drug product residue,and labelling materials? / Yes / No
If these inspections are performed, who performs them?
If you answered No to any of the questions above, please use the space below to provide additional information:
7. PACKAGING OPERATION PRACTICES
7.1 / Is each packaging line identified with product name, pack, size, and batch number? / Yes / No
7.2 / Are there procedures describing:
Proper control to ensure correct printed and unprinted
packaging components are used? / Yes / No
Verification of correctness of labelling at the
beginning of and throughout operations? / Yes / No
7.3 / Are there procedures for in-process control describing:
The point of sampling? / Yes / No
The frequency of sampling? / Yes / No
The number of samples taken? / Yes / No
The specification(s) to be checked? / Yes / No
The limit of acceptability for each specification? / Yes / No
7.4 / Are the results of in-process tests and inspection recorded and included in the Batch Packaging Record? / Yes / No
7.5 / Are storage containers for a bulk product, partly packed product or sub-batch labelled and marked with:
Product identity? / Yes / No
Quantity? / Yes / No
Batch number? / Yes / No
Status? / Yes / No
7.6 / Are finished or semi-finished packages observed off the packaging line:
Given to the supervisor of packaging? / Yes / No
Never returned directly to the packaging line? / Yes / No
Destroyed under supervision and the quantity recorded
if they cannot be confirmed as the same batch? / Yes / No
7.7 / Are products filled into their final containers and awaiting labelling and final packaging segregated and marked with the:
Product identity? / Yes / No
Batch number? / Yes / No
Status? / Yes / No
7.8 / Are measures taken to control the spread of dust during packaging,
especially of dry products, by:
Cleaning components and transfer containers before
bringing them to the packaging station or line? / Yes / No
Using dust collection devices? / Yes / No
Discouraging the use of brushes? / Yes / No
Discouraging the use of compressed air? / Yes / No
7.9 / Are supplies like lubricants, adhesive, inks, cleaning fluids etc. kept in containers:
Different from those used for drug? / Yes / No
Clearly labelled as to their contents? / Yes / No
7.10 / Is bringing personal medications into the packaging area strictly prohibited? / Yes / No
7.11 / Are pockets prohibited on uniforms or clothing worn in the packaging area? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
8. COMPLETION OF PACKAGING OPERATIONS
8.1 / Is the last production package carefully checked to confirm with specification on completion of the packaging operation? / Yes / No
8.2 / Are only finished products from a single packaging operation placed on a pallet? / Yes / No
8.3 / For partially filled cartons, is the quantity of contents indicated accordingly? / Yes / No
8.4 / Is inspection performed on each line after the packaging operations, to ensure that all of the following are removed:
Excess packaging components? / Yes / No
Remaining bulk drug? / Yes / No
Rejected packaging components? / Yes / No
Batch documentation, instructions and records? / Yes / No
8.5 / Are only properly identified packaging components and bulk products permitted to be returned to the ware house? / Yes / No
Are all codedpackaging materials that are rejected or are in excess:
Counted? / Yes / No
Destroyed under control of the supervisor? / Yes / No
Recorded, including their quantity, in the Batch Packaging Record? / Yes / No
8.6 / Are all components and bulk product reconciled under close supervision? / Yes / No
8.7 / Are the net quantities of components used for the batch recorded in the Batch Packaging Record? / Yes / No
8.8 / If any significant unexplainable yield discrepancy or failure to comply with specification is observed:
Is a thorough investigation performed and documented? / Yes / No
Is an investigation extended to other batches or products which also might be affected? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
9. QUALITY CONTROL
9.1 / Is the Quality Control (QC) function independent of production? / Yes / No
9.2 / Please describe the tests the QC laboratories are capable of performing:
9.3 / Do you use any contract QC laboratories? / Yes / No
If Yes:
Have you evaluated/qualified these laboratories? / Yes / No
Please list the types of testing contracted to these laboratories:
9.4 / Are there written plans and procedures for sampling? / Yes / No
9.5 / Which sampling plans/systems do you use for:
Packaging materials?
Bulk products?
Finished goods?
9.6 / Do you retain a sample of each batch? / Yes / No
If Yes, for how long?
9.7 / Are there formal written procedures for all tests performed? / Yes / No
9.8 / Do you use validated analytical methods for QC testing? / Yes / No
9.9 / Is there a written procedure to establish and manage analytical reference standards? / Yes / No
9.10 / Are analytical calculations checked by a second person? / Yes / No
9.11 / Do you perform trend analysis on analytical results? / Yes / No
9.12 / Do you have a written procedure for documenting and investigating outofspecification results? / Yes / No
9.13 / How long do you keep analytical testing records?
9.14 / Is critical analytical laboratory equipment fully qualified? / Yes / No
9.15 / Is there are maintenance plan/procedure for this equipment? / Yes / No
9.16 / Do you have a calibration scheme for this equipment? / Yes / No
9.17 / Does each analytical instrument have a log book? / Yes / No
9.18 / Does any laboratory equipment have software for control, or data capture and storage? / Yes / No
If Yes, is this software:
Validated? / Yes / No
Subject to change control procedures? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
10. QUALITY ASSURANCE
10.1 / Is the Quality Assurance (QA) function independent of production? / Yes / No
10.2 / Who is responsible for evaluation and approval of:
Specifications for components,in-process, and finished goods specifications?
Critical packaging process parameters?
10.3 / Do you have written procedures covering the release or rejection of material? / Yes / No
10.4 / Who is responsible for the release or rejection of finished goods?
10.5 / Are deviations and non-conformances investigated, assessed and filed? / Yes / No
10.6 / Do you conduct monitoring and periodic reviews of quality? / Yes / No
If Yes, what is the frequency?
10.7 / Does the QA function conduct internal audits? / Yes / No
If Yes, please describe their scope and frequency:
10.8 / Do you have a written complaints handling procedure? / Yes / No
10.9 / Do you have a written product recall procedure? / Yes / No
If Yes, briefly describe your product recall procedure:
10.10 / Describe how senior management is informed of quality related issues:
10.11 / Do you have a written change control policy or procedure? / Yes / No
If Yes, please describe:
How you evaluate quality risks before implementing changes
Describe how DNDi will be notified and approve changes
10.12 / Do you supply a certificate of GMP conformance with each batch? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
11. DISTRIBUTION
11.1 / Do you have systems/procedures for:
Selection of shipping packaging? / Yes / No
Selection of contract carriers/distributors? / Yes / No
Transport of temperature-sensitive goods? / Yes / No
Security of shipments? / Yes / No
Tracking and authentication of shipments? / Yes / No
11.2 / Does each shipping container bear a label identifying contents, supplier name, batch number, storage conditions and re-test/expiration date? / Yes / No
11.3 / Are container labels reconciled and the number of labels printed, used and destroyed recorded? / Yes / No
11.4 / Do you keep records of all shipments to customers, including batch number and quantity? / Yes / No
11.5 / Do you use re-usable containers? / Yes / No
If Yes, are they cleaned via validated procedures and inspected before re-use? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
12. Investigational Medicinal Products
12.1 / Do you have systems/procedures for the sourcing of Comparative Agents? / Yes / No
If yes, are Comparative Agents supplied by approved vendors? / Yes / No
Do you assure Comparative Agents are not counterfeit? / Yes / No
Do you have systems in place to monitor potential recall of Comparative Agents used in clinical studies? / Yes / No
12.2 / Do you have systems/procedures for the blinding of clinical studies? / Yes / No
If yes, do you have controls for the generation or importation of randomisation codes? / Yes / No
Do you prepare Patient Information Disclosure Sheets? / Yes / No
12.3 / Do you utilise telerandomisation techniques? / Yes / No
If yes, is the system fully validated? / Yes / No
12.4 / Do you have systems/procedures in place for the generation of multi-language label and translations? / Yes / No
If yes, is the system fully validated? / Yes / No
12.5 / Do you hold an IMP Manufacturers licence (EU) or equivalent (non-EU)? / Yes / No
If so, please provide copy.
12.6 / Do you have systems/procedures in place for the QP certification of IMPs (EU) or equivalent (non-EU)? / Yes / No
If you answered No to any of the questions above, please use the space below to provide additional information:
13. DATA INTEGRITY
13.1 / Do you have an approved data integrity policy? / Yes / No
If Yes, please provide the reference and effective date of the policy:
13.2 / Does your data integrity policy follow the principles of “ALCOA”?
(Attributable, Legible, Contemporaneous, Original or true copy, Accurate) / Yes / No
13.3 / Does your data integrity policy also apply to all metadata necessary to reconstruct a record of GMP activities? / Yes / No
13.4 / Is access to data systems restricted to authorised persons? / Yes / No
13.5 / Please describe measures taken to ensure data is secured from alteration, inadvertent erasure, deterioration or loss:
13.6 / Do you perform back-up of all data? / Yes / No
If Yes, please provide the frequency of data back-up:
13.7 / Are audit trails available to track creation, modification or deletion of data by operators (such as processing parameters and results)? / Yes / No
13.8 / Are audit trails available to track actions at the record or system level (such as attempts to access the system, rename or delete a file, change process parameters or limits)? / Yes / No
13.9 / Are data systems periodically reviewed to confirm that they remain in a valid and compliant state? / Yes / No
If Yes, please provide the frequency of review:
If you answered No to any of the questions above, please use the space below to provide additional information:
QUESTIONNAIRE COMPLETED BY:
TITLE:
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