/ CONFIDENTIAL
Supplier Evaluation: Drug Product Manufacturing (IMP) 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 manufacturing premises:
1.4 / Types of manufacturing operations performed:
1.5 / Non-sterile Dosage forms manufactured (e.g., tablets, capsules, semi-solids etc):
Sterile Dosage forms manufactured (e.g. vials, ampoules, lyophiles etc)
1.6 / Scale(s) of manufacturing of different dosage forms:
1.7 / Phases of Clinical Manufacturing Experience (I-IV)
1.8 / Storage Capabilities (CRT, 2-8C, -20C, -70C)
1.9 / Capability to manufacture blinded drugs/placebos (including procedures assuring neither mix-ups nor presence of potential blind-breaking characteristics):
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 recent inspection history (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 / Do you have a system or process to readily identify the level of compliance with training requirements? / Yes / No
3.5 / 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
3.6 / Please describe how the competency of staff is evaluated:
If you answered No to any of the questions of Section3 (Personnel), 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 manufacturing components and materials? / Yes / No
Preparation and control of labelling materials? / Yes / No
Manufacturing? / Yes / No
Quarantined finished goods? (This may be controlled by an
inventory system that doesn’t require separation) / Yes / No
Approved finished goods? (This may be controlled by an
inventory system that doesn’t require separation) / 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 handled 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 questions of Section 4.4, please describe specific measures
taken to prevent crosscontamination:
4.5 / Do your areas for manufacturing, 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 questions of Section 4.5,
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 manufacturing operations, including equipment cleaning, been completed and documented? / Yes / No
4.7 / Is all equipment qualified? / Yes / No
4.8 / Do you monitor the conformance of all utilities to their quality standards? / Yes / No
4.9 / Are plant utilities pipelines clearly identified and labelled? / Yes / No
4.10 / Is there a maintenance/preventative maintenance program for all equipment? / Yes / No
4.11 / Do you have written maintenance and calibration procedures for critical equipment? / Yes / No
4.12 / Is there a written cleaning plan/procedure for all equipment? / Yes / No
4.13 / Have the cleaning procedures been validated? / Yes / No
4.14 / Is any manufacturing 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 questions of Section 4, please provide the space below to provide additional information:
5. BULK MANUFACTURING COMPONENTS AND MATERIALS
5.1 / Are incoming bulk manufacturing materials inspected, sampled and tested according to written procedures? / Yes / No
5.2 / Do you have written specifications for all incoming manufacturing materials, including cleaning agents for manufacturing equipment and premises? / Yes / No
5.3 / Do you routinely test incoming manufacturing 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 manufacturing materials, components and supplies? / Yes / No
If you answered No to any questions of Section 5, please use the space below to provide additional information:
6 . MANUFACTURING SET-UP
6.1 / Do you manufacture each batch according to pre-approved manufacturing procedures/instructions (e.g., Master Batch Record)? / Yes / No
6.2 / Does each batch manufacturing record contain complete details of:
Description, batch numbers and quantities of materials used? / Yes / No
Samples of labelling used? / Yes / No
Date of manufacturing? / 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 manufacturing? / Yes / No
6.3 / Please describe the changeover and cleaning procedures briefly:
6.4 / Is only one product batch processed in a manufacturing room/area at any given time? / Yes / No
6.5 / Are all deliveries of API and manufacturing components checked and verified for their correctness against the approved Master Batch Record of other specific order? / Yes / No
6.6 / Before a manufacturing operation starts in a work area or on a manufacturing line is an inspection conducted to ensure:
General cleanlinessof the line and the immediate area? / Yes / No
Removal of all previous drug product, drug product residue,
and packing andlabelling materials? / Yes / No
Current calibration of all equipment/instruments? / Yes / No
Equipment on a Preventive Maintenance Schedule? / Yes / No
If these inspections are performed, who performs them?
If you answered No to any questions of Section 6, please use the space below to provide additional information:
7. MANUFACTURING OPERATION PRACTICES
7.1 / Is each line identified with product identifier or codeand batch number? / Yes / No
7.2 / Are there procedures describing:
The verification of the correctness of the manufacturing process at the
start and throughout manufacturing operations? / Yes / No
Proper control to ensure correct manufacturing
raw materials and components are used? / Yes / No
Proper control to ensure correct printed and/or unprinted
packaging components are used? / Yes / No
Controls and processes to manufacture with quarantine materials? / 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 executed Batch Manufacturing Record? / Yes / No
7.5 / Are storage containers for a bulk product, partly packed product or sub-batch labelled and marked with:
Product identity or code? / Yes / No
Quantity? / Yes / No
Batch number? / Yes / No
Status? / Yes / No
7.6 / Are products filled into their final shippers or containers and awaiting labelling and final packaging segregated and marked with the:
Product identity or code? / Yes / No
Batch number? / Yes / No
Status? / Yes / No
7.7 / 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
7.8 / Please describe your process validation practices briefly:
If you answered No to any of the questions of Section7, please use the space below to provide additional information:
8. COMPLETION OF MANUFACTURING OPERATIONS
8.1 / Is the last production unit carefully checked to confirm with specification on completion of the manufacturing operation? / Yes / No
8.2 / Are only finished products from a single manufacturing 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 or work area after the manufacturing operations to ensure that all of the following are removed:
Excess manufacturing and packaging components? / Yes / No
Remaining bulk drug? / Yes / No
Rejected production units? / Yes / No
Batch documentation, instructions and records? / Yes / No
8.5 / Are only properly identified manufacturing components and bulk products permitted to be returned to the ware house? / Yes / No
8.6 / Are all codedmaterials 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 Record? / Yes / No
8.7 / Are all components and bulk product reconciled under close supervision? / Yes / No
8.8 / Are the net quantities of materials and components used for the batch recorded in the Batch Manufacturing Record and the yields compared with expectation? / Yes / No
8.9 / 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
Batch number? / Yes / No
Status? / Yes / No
8.10 / Who reviews and approves manufacturing records (executed Batch Records) after completion of manufacturing?
8.11 / How long do you keep these records?
If you answered No to any questions of Section 8, 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 / Are there written plans and procedures for sampling? / Yes / No
9.4 / Which sampling plans/systems do you use for:
Raw materials?
Finished goods?
9.5 / Do you retain a sample of each batch? / Yes / No
If Yes, for how long?
9.6 / Are there formal written procedures for all tests performed? / Yes / No
9.7 / Do you use validated analytical methods? / Yes / No
9.8 / Is there a written procedure to establish and manage analytical reference standards? / Yes / No
9.9 / Are analytical calculations checked by a second person? / Yes / No
9.10 / Do you perform trend analysis on analytical results? / Yes / No
9.11 / Do you have a written procedure for documenting and investigating outofspecification results? / Yes / No
9.12 / How long do you keep analytical testing records?
9.13 / Is critical analytical laboratory equipment fully qualified? / Yes / No
9.14 / Is there are maintenance plan/procedure for this equipment? / Yes / No
9.15 / Do you have a calibration scheme for this equipment? / Yes / No
9.16 / Does each analytical instrument have a log book? / Yes / No
9.17 / 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 questions of Section 9, 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 manufacturing 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? If a Qualified Person (EU), please give the name(s).
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 and, if applicable the Qualified Person (EU) 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?
HowDNDiwill be notified of and approve changes?
10.12 / Are any key activities critical to cGMP compliance outsourced to third party providers, if yes please list
10.13 / Do you supply a certificate of analysis with each batch? / Yes / No
10.14 / Do you supply certification of BSE/TSE conformance for each batch? / Yes / No
10.15 / Do you supply a certificate of GMP conformance with each batch? / Yes / No
If you answered No to any questions of Section10, 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
If you answered No to any questions of Section11, please use the space below to provide additional information:
12. DATA INTEGRITY
12.1 / Do you have an approved data integrity policy? / Yes / No
If Yes, please provide the reference and effective date of the policy:
12.2 / Does your data integrity policy follow the principles of “ALCOA”?
(Attributable, Legible, Contemporaneous, Original or true copy, Accurate) / Yes / No
12.3 / Does your data integrity policy also apply to all metadata necessary to reconstruct a record of GMP activities? / Yes / No
12.4 / Is access to data systems restricted to authorised persons? / Yes / No
12.5 / Please describe measures taken to ensure data is secured from alteration, inadvertent erasure, deterioration or loss:
12.6 / Do you perform back-up of all data? / Yes / No
If Yes, please provide the frequency of data back-up:
12.7 / Are audit trails available to track creation, modification or deletion of data by operators (such as processing parameters and results)? / Yes / No
12.8 / 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
12.9 / 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:
SIGNATURE & DATE: