Professional Documents
Culture Documents
Herny Prasetya
Jakarta, 24 Januari 2019
OUTLINE
Pengenalan Manajemen Risiko Mutu – Latar Belakang,
Persyaratan Regulatori
Pendahuluan,
Definisi, Process MRM
Tujuan,
Prinsip Dasar
Ruang Lingkup
“risk-based”
concepts and
principles
Q11
Substance (Q11) - May 2012
Q8
Lifecycle Management (Q12)
Draft November 2017
Q9
Tujuan
Penggunaan
• Tanggung jawab • menyelamatkan jiwa, atau
pencapaian sasaran • memulihkan kesehatan, atau
mutu oleh Manajemen • memelihara kesehatan
puncak
• Partisipasi dan komitmen
dari
• semua personel di
Sistem
berbagai departemen Mutu
• pemasok dan
distributor. OBAT
• aman (safe)
• berkhasiat (effective)
Tidak
• bermutu (quality)
Memenuhi
menimbulkan
Persyaratan • Ijin edar RISIKO
• Uji klinis SQuIPP
Design
Risiko Q9
Process
Materials Manufacturing
Facilities
Distribution
Patient
Q8 Q10
Connecting Pharmaceutical Knowledge ispe.org 15
HIGH
t
en
em
ov
Using Q9
pr
im
Quality Risk
l
ua
in
Management
nt
co
principles
cGMP cGMP
regulatory
cGMPcGMP
regulatory cGMP
regulatory
oversight
(Inspection)
oversight
Q8 regulatory
oversight Q10 regulatory
oversight
(Inspections)
oversight
& &
Company’s Company’s
Company’s
Quality system Q9 Company’s Q9 Quality system
Quality system Quality system
Post Continuous
Approval
approval
Change Improvement
PAC
PAC toto
change
(PAC) Continuous
Continuous
Risk
Improvement
Improvement
Risk Risk
(perceived
(P/R)& real)
Connecting Pharmaceutical Knowledge ispe.org
Based on A.Hussain, FDA, September 2004
Connecting Pharmaceutical Knowledge ispe.org 18
TIPE RISIKO PADA PRODUK
Intrinsic Risks Extrinsic Risks
• Those inherent to a drug, given the • Can be defined as unintended risks to
nature of certain biochemical reactions the patient arising from events or
within the body when exposed to the circumstances unrelated to the drug
drug or its constituent parts. product itself; for example, dosing
errors, counterfeiting or tampering, drug
• Intrinsic risks generally surface during shortages, or risks introduced during
research and development and in the manufacturing, packaging, labeling,
clinic and are weighed against the distribution, or storage.
overall medical benefits of the product
when determining whether the drug is • A critical subset of these are quality
suitable for commercial sale. risks — risks to patients that are
associated with the quality of the
• QRM practitioners should possess medicinal product.
adequate knowledge of these risks to
understand the underlying relationship • These are the risks that constitute the
between these and the quality risks that focus of quality risk management.
are the focus of QRM
Connecting Pharmaceutical Knowledge ispe.org
19
KARAKTERISTIK dan PERBEDAAN
Intrinsic Risks Extrinsic Risks
Originated from Drug product/substances External events/ circumstances
Dosing/medication errors
Adverse reaction
Counterfeiting
Types Contraindication
Shortages
Other risks
Quality Risks
Complaints
Clinical studies Deviations
Identified through
Post market pharmacovigilance Proactive quality risk
management
Pendahuluan,
Definisi, Process MRM
Tujuan,
Prinsip Dasar
Ruang Lingkup
PRODUCT
CHANGE THIRD PARTY ENVIRONMENT STABILITY
QUALITY PP &PQMS
MANAGEMENT MANAGEMENT MONITORING MONITORING
REVIEW
Pendahuluan,
Definisi, Process MRM
Tujuan,
Prinsip Dasar
Ruang Lingkup
Parameters
probability
for
evaluating risks
severity
Refers to
Refers to
Refers to
time
past today future
Connecting Pharmaceutical Knowledge ispe.org 33
PRINSIP UTAMA
Pendahuluan,
Definisi, Process MRM
Tujuan,
Prinsip Dasar
Ruang Lingkup
Komunikasi Risiko
Analisis Risiko
Penerimaan Risiko
Pengkajian Risiko
3 pertanyaan dasar
• What might go wrong
Penilaian Risiko • What is the likelihood (probability) it
will go wrong?
IDENTIFIKASI RISIKO
• What are the consequences (severity)?
ANALISIS RISIKO
EVALUASI RISIKO
Penilaian Risiko
IDENTIFIKASI RISIKO
ANALISIS RISIKO
EVALUASI RISIKO
Penilaian Risiko
IDENTIFIKASI RISIKO
“seberapa besar probabilitas akan menjadi
ANALISIS RISIKO salah?”
Estimasi risiko yang terkait dengan bahaya yang
EVALUASI RISIKO teridentifikasi
• Menghubungkan secara kualitatif atau kuantitatif
kemungkinan terjadinya (probabilitas) dan keparahan
kerugian/bahaya yang timbul.
• Pada beberapa alat bantu manajemen risiko,
kemampuan untuk mendeteksi bahaya (detektabilitas)
adalah faktor utama dalam estimasi risiko.
IDENTIFIKASI RISIKO
“What is the likelihood (probability) it will go wrong?”
ANALISIS RISIKO • Estimasi risiko yang terkait dengan bahaya yang teridentifikasi
• Menghubungkan secara kualitatif atau kuantitatif
kemungkinan terjadinya (probabilitas) dan keparahan
EVALUASI RISIKO kerugian/bahaya yang timbul.
• Dalam beberapa alat bantu manajemen risiko, kemampuan untuk
mendeteksi bahaya (detektabilitas) adalah faktor utama dalam
estimasi risiko.
Apa konsekuensinya (tingkat keparahan) ?
• Membandingkan risiko yang ter
identifikasi dan dianalisis terhadap
kriteria risiko yang ditetapkan.
• Evaluasi risiko mempertimbangkan
kekuatan bukti semua pertanyaan
dasar. Connecting Pharmaceutical Knowledge ispe.org
PENILAIAN RISIKO
Pengambil Keputusan
Seseorang yang memiliki
kompetensi/kemampuan dan diberi otoritas
untuk mengambil keputusan manajemen risiko
mutu secara tepat dan cepat
Manufacturing
Technology
Commercial
Pharmaceutical
Patient
Development
Transfer
needs Product Control
Process
design design Strategy
Business
needs
Submission/dossier GMP
Inspections Inspections
MRM adalah bagian kritis dari quality culture mendorong risk based
decision making
Mendorong integrasi MRM pada Sistem Mutu Perusahaan
mengoordinasi implementasi dan alokasi sumberdaya
menentukan prioritas
Design
Risiko Q9
Meningkatkan
Process perlindungan
dengan
Materials Manufacturing mengurangi risiko
saat
Facilities menggunakan
Distribution
obat
Patient
Risk Assessment
Risk Identification
Risk Analysis
Risk Evaluation
unacceptable
Risk Reduction
Team
approach Risk Acceptance
Risk Review
Review Events
ICH Q9
Connecting Pharmaceutical Knowledge ispe.org 70
BPOM
Kaji dan kendalikan
PIC/S PS/INF 2010 Quality Risk Management Implementation of ICH Q9 in the pharmaceutical field
an example of methodology from PIC/S
Connecting Pharmaceutical Knowledge ispe.org 71
• MRM MERUPAKAN BAGIAN KRITIS DARI BUDAYA MUTU
• PERAN MANAJEMEN PUNCAK SANGAT MENENTUKAN
PENERAPAN MRM
• MRM MERUPAKAN SALAH SATU JALAN UNTUK
PERBAIKAN BERKELANJUTAN