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Syrup Medicines Banned in Indonesia! Isn’t there a way to formulate safe syrup products?

10/25/2022

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Syrup Medicines Banned in Indonesia! Isn’t there a way to formulate safe syrup products?
The health ministry of Indonesia has temporarily banned the sale of all syrup and liquid medicines, citing the risks to children (according to a BBC news report). In a statement, the ministry explained that acute kidney injury (AKI) has been linked to syrup medicines. The government cited a sharp increase in AKI cases among children, most of them under five years of age. However, the number of acute kidney failure cases could be much higher than reported.
 
Higher than accepted levels of diethylene glycol and ethylene glycol were found to be present in the products recovered from patient’s homes. Children suffering from AKI had allegedly been using syrups that contained diethylene glycol and ethylene glycol in very small amounts. Currently, there are 206 confirmed cases of AKI in Indonesia, of which 99 were fatal. However, the true number is likely to be higher.
 
As per the BBC news report the Indonesian authorities have so far not disclosed the brands or types of syrup medicines linked to sick children; instead, just temporarily banned the sale and prescription of all syrup and liquid medicines.
 
Earlier this month, cough syrup-linked child deaths were reported from African country The Gambia. The reason then was higher than accepted levels of diethylene glycol and ethylene glycol in syrups. ( A report in India's one of the leading newspaper Economic Times stated that the Medicines Control Agency MCA, has not yet found definitive links between the deaths and the cough syrup).

Unfortunately, we have been witnessing such tragedies since 1937, when the first elixir tragedy was reported in the United States.
 
Further to that, compliance procedures and regulations were strengthened, and for a few decades, it has helped bigtime in curbing such fatalities.
 
Over the years, pharma operations have graduated from ‘quality control’ to ‘quality assurance’ and now ‘quality-by-design’. One of the fundamental principles of quality-by-design (QbD) while formulating drug products is that safety is built-into the product by design. But then a quick question that pops up in my mind is- Are syrups safe?
 
In my view and I'm sure you will agree with me, there can be no justification to such tragedies. As an operational excellence leader, I believe that in addition to ensuring cGMP and quality compliance while manufacturing drug products, it is probably the need of the hour to re-think formulation strategies for syrup medications.
 
Go for syrups sans propylene glycol!
 
This is surely a challenge for pharma formulation development scientists, but it will be efforts worthwhile. Firstly, it will stop such potential tragedies and secondly, syrups shall truly become patient-friendly!

​
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Organoids As Models of the Human Brain

10/16/2022

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organoids as models of the human brain
Here's an exciting update on innovation in drug research!

The successful transplantation of human brain cells into a rodent's brain has made it possible for scientists to study the complex brain circuits and psychiatric disorders. The cells, known as organoids, are smaller than neurons grown in vitro. Researchers study these organoids to see how they integrate with the rodent's natural circuits.
 
Scientists have successfully implanted and integrated human brain cells into young rats' brains

In an exciting breakthrough, scientists have successfully implanted and integrated human brain tissue into the brains of young rats. The transplanted human cells did not cause any problems and were found to have no negative side effects. While this is an impressive accomplishment, it may not be the end of the story for humans.
 
The transplanted human neurons successfully teamed up with the rat's vascular system, which provides oxygen and nutrients to neurons. The scientists then performed an experiment to test how the human neurons reacted to external stimuli. They found that the implanted human neuron produced electrical activity when air passed across the rats' whiskers. This result suggests that the human neurons could influence the rat's behavior.
 
Organoids are smaller than neurons grown in vitro
 
Organoids, or cell cultures, are a relatively new technology. These small cultures of neurons have been used in the past to model aspects of human neocortical biology, including a variety of diseases. Organoids are particularly useful in studying infectious and genetic diseases of the brain. They can also be used to discover potential therapeutic reagents.
 
Organoids are similar to neurons in size and complexity, although they contain fewer neurons. Their cell lineage network is based on the same gene network as neurons grown in vivo. The cell lineage network for organoids and neurons is largely constant, except for variations in cell states during neurogenesis.
 
They integrate with rodents' own circuits
 
The rat-human hybrid brains are a ground-breaking advancement, offering new opportunities to study neurological disorders and raising ethical questions. These miniature human-brain-like structures can respond to environmental cues, allowing researchers to test therapies for disorders of the human brain. These brains were developed with the aim of studying the development and function of brain circuitry, including those that control behaviors and processes sensations.
 
The research involved genetically engineering human neurons and integrating them into the brain circuits of rats. The cells grew six-fold longer than those in petri dishes and were just as active as those in humans. They were able to send signals to nearby neurons and to distant ones, triggering the same responses in the rat brain.
 
They study complex psychiatric disorders
 
Scientists have successfully implanted and integrated a cluster of human brain cells into the brain of a newborn rat, an effort that could help them develop treatments for neuropsychiatric disorders. The goal of such experiments is to better understand complex psychiatric disorders and the mechanisms that drive them, and to develop new treatments to treat them. This new research method could be a game changer in psychiatric treatment.
 
The success of the experiment is promising because scientists can build pieces of human brain tissue using stem cells grown in petri dishes. They have already done this with more than a dozen brain regions. But these experiments are challenging.
 
They could aid early testing of drugs
 
Research teams have developed a technique for growing brain organoids from human stem cells. These organoids are tiny models of the human brain and are useful for studying how it works.
 
This technology has many applications for drug testing. For example, scientists have used human brain organoids for testing drugs for psychiatric conditions, such as schizophrenia. These organoids have been successfully implanted and integrated into newborn rats. Researchers are now able to study the effects of drugs on the brain of these animals in a much more accurate way than they could previously.

Disclaimer: Information presented here is for educational purpose and not medical advice. Do not self-prescribe medicines. Consult a registered medical doctor before taking medicines. 

Related Reading:
  1. Kaizen for pharmaceutical, medical device and biotech industries​
  2. How to cut costs strategically using Kaizen
  3. Top 30 Continuous Improvement Tools

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Categories:  Life Sciences | Innovation Management

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How Can Pharma and Biotech Companies Maintain Quality While Rapidly Scaling Up Operations

10/15/2022

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One of the biggest challenges facing pharma and biotech companies is scaling-up production and maintaining high quality standards. This is difficult for a variety of reasons. Fortunately, there are a number of ways to scaleup without compromising quality. Here are some ideas to consider: Outsourced development and manufacturing services, Technology transfer, Effective batch control, and Record-keeping.
 
Outsourced development and manufacturing services
 
Outsourced development and manufacturing services are an increasingly attractive option for biopharmaceutical companies. Pharma-biotech companies are often constrained by budgets or lack of resources, and outsourcing offers a flexible and scalable solution. Outsourced services can help pharma-biotech companies scaleup operations and maintain quality. Pharma-biotech companies typically evaluate three to six molecules during the early stages of product development, and they should look to outsource at this stage of their development. (Full disclosure- I am not canvassing for any CRO-CDMO).
 
Technology transfer
 
Technology transfer is a critical part of the production process for pharma-biotech. This process requires careful planning to ensure that quality remains high throughout the entire process. The transfer process must cover all aspects of process development, from analytical testing to packaging. In addition, the process should be transparent and cover all the bases, so that there are no unexpected occurrences or issues.
 
Relevant tech-transfer processes and effective talent management of people doing those tech-transfers assumes significance. I’ve a separate post on ‘Best practices for talent management in pharma companies’, you may check it out here.
 
Record-keeping
 
As pharmaceutical and biotech manufacturers scaleup their operations and seek to gain a competitive advantage, record-keeping is increasingly important.
 
Record-keeping helps ensure that processes and data are accurate and consistent. It also enables companies to achieve greater productivity, leading to lower production costs through economies of scale. This improves the bottom line and gives a company a competitive edge. However, pharma- biotech companies are also required to adhere to stringent regulatory requirements and safeguard the integrity of data.
 
Digitalization is a promising solution for efficient and effective record-keeping. Having said that, digitalization involves cost and not all companies may have extra funds to spend on it right away. If that’s the case, I would say- Companies can continue to use non-digital means for record-keeping while making sure to implement continuous improvement tools such as Kaizen, to keep their processes relevant.
 
Effective batch control
 
In order to ensure the quality of their products, pharma and biotech companies must make use of more data-driven and agile manufacturing methods. Currently, most data are stored in paper binders or siloed applications, which are not easily consumable by operators. This leads to a high risk of human error and a significant amount of overhead.
 
Installing suitable error-proofing measures to processes can nullify such issues. To know more check out: Mistake-Proofing Pharmaceutical Product Development, Manufacturing and Logistics, Cost Savings via Poka Yoke 
 
Risk-based approach to product development
 
Using a risk-based approach for product development, pharma-biotech companies can help avoid costly delays. Managing risk effectively is a key component of the drug development process, but it is often neglected. A comprehensive risk management plan based on ICH Q9 can help minimize overall risks and ultimately result in a more efficient development process and higher-quality product.
 
Single-use equipment
 
Single-use equipment can provide several benefits to pharma and biotech manufacturing. It eliminates the need for cross-contamination in the production process. Single-use solutions also provide greater mechanical resistance against impacts and tearing.
 
Overall, based on my first-hand experiences with pharma-biotech manufacturing processes, I would say that- “It is all in your setup and strategy around product manufacturing. They must focus upon three prime areas- (1) A robust quality system. (2) A thorough understanding of your quality data and (3) An engaged quality aspiring work culture. And these three elements cannot be implemented in retrospect.
 
If you need to scale-up and do not have a handle on these three elements, then I shall suggest, please stop, and re-evaluate your scaleup strategy. Because, not having a state of control over systems and processes and yet moving on with scaleup activities, will end up in gawky quality gaps and bigtime materialization of risks and losses. 

Related Reading:​
  1. Kaizen for pharmaceutical, medical device and biotech industries
  2. How to cut costs strategically using Kaizen
  3. Streamline processes and workflows with Gemba Walk.
  4. Top Ten Strategic Decision-Making Tools for Operational Excellence

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Categories: Lifesciences | Operational Excellence

Keywords and Tags:
#operationalexcellence #qualitymanagementsystem #QMS  #pharmaquality  #riskbasedapproach
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Best Practices for Talent Management in Pharma Companies

10/14/2022

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best practices for talent management in pharma companies
Talent retention is one of the critical aspects of increasing operational excellence. It is the people within a company that grow the business. And hiring and retaining the right skill means, organizations must have smart business processes underlying recruiting, hiring, training and engaging employees. And these processes must be revisited regularly to keep them relevant.
 
As the pharma industry continues to evolve and create new technologies, it's vital that it attracts top talent to join the ranks. To get the best people for the job, pharma companies can employ best practices for talent management. These practices include engaging in career events and partnering with industry associations. Many such associations organize training programs and educational seminars for its members, and even hackathons.
 
While the pharma industry relies heavily on recruitment agencies to recruit sales and marketing talent, recruiting talent for R&D is a different story. It can be difficult to recruit talent for this area because of its specialized skills and requirements. Many pharma companies do not use recruitment agencies for this purpose, although this is not necessarily a bad thing.
 
Pharma companies need to build a strong internal talent pipeline. The industry is dynamic, and pharma companies need leaders who can understand the challenges it faces. The best way to do this is to develop talent from within and ensure that the right people have the right skills to succeed. The shift to remote work has forced pharma companies to create new strategies for cultivating their future leaders.
 
An effective applicant tracking system can help pharmaceutical companies source highly specialized talent. It can also reduce drop-off rates and improve speed-to-market. Additionally, the right sourcing strategies can empower talent to become recruiters themselves by developing an internal talent mobility program.
 
Managing diversity and inclusion initiatives is another way to improve talent engagement. Diversity and inclusion initiatives will help employees feel more connected to the company. Employees who feel connected to their employers will be more engaged and productive.
 
Moreover, leadership in pharma companies requires a diverse skill set. Developing a balanced set of soft and hard skills will help a person excel in their role. Those working in pharma companies must have the ability to adapt and handle a variety of situations. For example, a scientist needs to be comfortable presenting to different lines of business, while a sales leader must be confident discussing highly technical product innovations.
 
The right talent management strategy helps companies attract and retain the best people. Without a proper talent pool, a company cannot respond to new challenges and leapfrog its competitors. This is why it's crucial for pharma companies to invest in developing their people through proper talent management initiatives.

Related Reading:
  1. Top Ten Strategic Decision-Making Tools for Operational Excellence
  2. ​How to cut costs strategically using Kaizen
  3. Top 30 Continuous Improvement Tools
  4. Top 10 Change Management models

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Categories:  HR Development | Lifesciences

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Gefapixant can become a 'game changer' in treating people with persistent cough, reveals study

10/10/2022

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Gefapixant can become a game changer in treating people with persistent cough reveals study.
A new drug Gefapixant 45 mg twice per day is the first treatment to show efficacy with an acceptable safety profile in phase 3 clinical trials for refractory chronic cough or unexplained chronic cough, revealed a study paper published in The Lancet.
 
If Gefapixant becomes available in the market, it is expected to become a ‘game changer’  in the field of respiratory medicine, by treating thousands of people suffering from severe or persistent cough.
 
A persistent cough is a cough that lasts for more than eight weeks. Chronic cough is responsible for a decrease in quality of life. Chronic cough affects approximately 5–10% of the global population. In UK itself, 4 to 12% of people suffer from it as per published reports.
 
Many patients with refractory chronic cough or unexplained chronic cough have a long-term disease with substantial deterioration in their quality of life.
 
Currently, there are no approved therapies for refractory chronic cough or unexplained chronic cough, and clinicians often rely on off-label treatments such as morphine, amitriptyline, gabapentin, pregabalin, and speech therapy. Thus, an unmet need remains for safe and effective medications for chronic cough.

The discovery of a new class of drugs—P2X3 receptor antagonists appear to be effective hope to this debilitating problem.

Gefapixant is an oral P2X3 receptor antagonist . As per the news report, a global trial conducted in 17 to 20 countries, involving nearly 2000 individuals found that the Gefapixant reduces chronic coughing in nearly 60 to 70 percent of people.
 
The news report also stated- the study indicated that some of the patients found that their taste ability was either affected or disappeared when they were consuming the drug. However, they later believed that the side effects are worth paying for as they are now relieved from coughing and not just that, they are now able to sleep better than they used to when they were coughing. 

Here’s the link to the study papers https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02348-5/fulltext and  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02438-7/fulltext

Disclaimer: The content of this blog is for educational purpose only and not medical advice. Consult a registered medical doctor before taking any medicine.

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Gambia cough syrup tragedy: How can we stop such catastrophe?

10/9/2022

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Gambia cough syrup tragedy- how to stop such catastrophe
Dozens of child deaths have been reported recently in African country The Gambia. The deaths are allegedly linked to cough syrups containing unacceptable levels of diethylene glycol and ethylene glycol.
 
Diethylene glycol and ethylene glycol are known toxic items and are ‘source-related’ impurities of the solvent used in the cough formulation. At the outset, for those new to this topic, let me briefly explain what is meant by ‘source- related’ impurities- There are broadly two types of impurities in drug products- (1) Source-related impurity and (2) Impurities arising as a result of product manufacturing and/or generated during the shelf-life of a product. These impurities are referred to as degradation products.
 
The source-related impurities are traces of substances in the raw material in lieu of its manufacturing. These source-related impurities cannot be totally avoided but must be controlled and must be within permissible limits mandated in the pharmacopoeia. Further, these source-related impurities must be within acceptable limits in the finished formulation (whenever that raw material is used) at all times until after the expiration of that finished formulation.
 
Same goes for the degradation products, they too (if present) must be within limits stated in the product monograph. If the impurity levels get higher than accepted limits, it can cause minor to critical safety concerns.
 
Coming back to this unfortunate incident…

​Deaths linked to diethylene glycol from cough syrup was first reported in the year 1937 in the United States, the ill-famous ‘Elixir Tragedy’.
 
Since that incident, regulators and pharma companies worldwide have put in stringent cGMP (current good manufacturing practices) criteria in drug product development thru manufacturing as well as post-marketing surveillance. The fundamental objective of cGMP is to ensure quality, efficacy and safety in drug product at all times until after its expiration. An incident such as this one, prima facie means a break-off from the norms i.e. non-compliance to the cGMP process.
 
Also, cGMP does not mean ‘best practices’ implemented only during manufacturing. cGMP is a wide-spectrum best practice and is applicable to all upstream and downstream processes of a product’s lifecycle. Non-compliance in adhering to these ‘best practices’ at any stage of the upstream and/or downstream processes can lead to mishaps, even fatalities.
 
So, what happened in this case? Why so many people died after taking a cough syrup? Why did the syrups have unacceptable quantities of diethylene glycol in them? As a member of the pharma fraternity such questions came my way (from friends and acquaintances) for the past few days. Since this matter is under investigation by competent authorities, we'll know in the coming days. But our objective as responsible pharma professionals, is not to just find out what happened in this unfortunate case, but also proactively ensure that such situations do not happen in the future.
 
In fact, I shall say- selling a safe product to the consumer is the seller’s prime responsibility, no two ways about it. Hence, not just drug products, but all products must have the desired quality attributes and must be safe in the hands of the user.  But how can companies ensure this?
 
There are several ways to achieve this. But the surest and fastest route is to- Start implementing QbD (quality-by-design) in the product’s value chain, and mistake-proof all processes in the product’s supply chain.
 
Mistake-proofing means you don’t leave any scope for errors to happen while working the process. For example, try putting a two-pin or a three-pin plug into a socket. It won’t fit-in unless inserted the right way. Another example of process mistake-proofing is a washing machine. If you were to flip open a washer’s door while it was running its cycle, the machine immediately stops. But the moment you shut back the door it re-starts! Such mistake-proofing with a plug's or washer's design and operation is to prevent accidents i.e. consumer safety.
 
Pharma companies must couple cGMP with mistake-proofing; that is, apply appropriate error-proofing measures to all its technical and business processes.
 
Some of the promising and time-tested error-proofing tools are Poka Yoke, FMEA, Visual Management, CAPA etc. I’ve separate posts on Poka Yoke and Visual Management, do check them out …

  1. Improve Process Efficiency with Visual Management
  2. Mistake-Proofing Pharmaceutical Product Development, Manufacturing and Logistics, Cost Savings via Poka Yoke
  3. Mistake-Proofing Pharmaceutical Products: What can we learn from Valsartan, Losartan and Irbesartan recalls?
  4. Valsartan, Irbesartan, Losartan Product Recalls- What are the Lessons for Pharmaceutical Industry?

News update- Subsequently, a report in India's one of the leading newspaper Economic Times stated that the Medicines Control Agency MCA and The Gambian drug regulatory authorities have not yet found definitive links between the deaths and the cough syrup, and that the cause of child deaths is still unknown.

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Categories:  Life Sciences | Mistake-Proofing

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#Gambiatragedy #coughsyruplinkeddeaths #diethyleneglycol #mistakeproofingprocesses #cGMP #PokaYoke  #FMEA #VisualManagement  #GambiaChildDeaths
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Bar Code, QR Code, RFID to Stop Counterfeit Drugs

10/7/2022

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bar code, QR code, RFID to stop counterfeit drugs
Mandatory affixing of bar code or QR code on pharmaceutical packages sold in India is topping news headlines. This move is likely to detect fake meds and help put a brake on counterfeit drugs. Newspaper reports in India state that the government is in the process of introducing strong measures to curtail the menace of fake drug sales, improve drug safety and security.
 
Drug counterfeiting is a serious problem both in developed and developing countries.  To prevent the sale of spurious drugs, the government has announced that pharmaceutical companies will be required to display a barcode and QR code on their medicines. These codes shall contain information such as the drug name, brand name, manufacturer’s name and address, batch number and expiration date to ensure that the drugs are genuine and safe for patients. These new technologies are expected to reduce the cost of medical supplies and improve patient safety.

The fight against fake medicines is important not only for patients but also for the companies themselves. Diverted products are sold at cheaper prices than the legitimate product and can cause illnesses (to consumers) and damage a company's reputation.
 
The government of India is moving towards a comprehensive new regulatory framework to prevent the spread of fake medicines. In India, the Ministry of Health and Family Welfare has recently issued draft regulations mandating the use of a 2D barcode on pharmaceutical packages. Though the move to impose a barcode on pharmaceuticals is hailed by experts, the pharma industry was reportedly hesitant initially, citing the cost of the technology. Since the concept was first proposed (a decade ago), the cost of the technology has dropped significantly, and the Indian pharma industry apparently welcomes the move ...
 
QR code
 
Introducing QR code to popular drugs and medicines will help consumers and healthcare professionals identify genuine medicines and stop the supply of spurious and counterfeit drugs. The Indian authorities plan to implement this scheme phase-wise, starting with top brand medicines with a market share of at least 35%. These drugs are at the highest risk of being faked, so this technology has great potential to save lives.
 
Fraudulent and counterfeit medicines continue to plague the Indian pharma industry. Using the QR code to track medicines from the factory to the patient is an effective way to combat this issue. 
 
The new generation of anti-counterfeiting technologies is designed to work with the barcode and make it "copy-proof" to prevent counterfeiting. This is important, as counterfeiters will use any means necessary to keep their business afloat. With a non-clonable barcode, the counterfeiter's product will not survive authentication and will be flagged as a fraudulent product.
 
Despite its potential benefits, the lack of uniformity in the use of barcodes and QR codes might make it difficult to prevent counterfeit medicines and improve the safety of patients. Perhaps a centralized source giving the QR/ bar code to the entire pharma industry might ease the challenges (around QR coding) while augmenting the benefit.
 
By utilizing the bar code and QR code on pharmaceutical packaging, users can verify the authenticity of a medicine online. The QR code/bar code system shall be designed to prevent the creation of two identical serial numbers on a single piece of pharmaceutical packaging. The move is likely to prevent spurious and counterfeit drugs. They can also be used to track and trace medicines and provide a unique serial number.
 
Track & Trace system
 
A Track & Trace system can be a huge help in stopping spurious and counterfeit drugs. These systems are increasingly being promoted as preventive measures against drug counterfeiting, including RFID (Radio Frequency Identification Device)  technology and 2D Data Matrix codes. However, the effectiveness of these systems is still unclear. Although they can identify counterfeit drugs at the point of dispensation, they require extensive infrastructure, resources and time to implement. Moreover, this would be particularly difficult for low-income countries.
 
Creating a Track & Trace system would allow for greater transparency in the pharmaceutical supply chain, and also help to detect and prevent spurious and counterfeit drugs. It would also improve public health and protect wealth by allowing for faster recalls of harmful drugs. Lastly, the system would ensure smooth communication between stakeholders and promote ethical business practices.
 
As the cost of counterfeit drugs continues to rise, the pharmaceutical industry is seeking cost-effective ways to prevent them from entering the supply chain. Moreover, track & trace technology will help drug makers to identify leaks in their distribution systems and enforce their contract terms. For this reason, the industry is keen to introduce this new technology into the supply chain. These technologies have the potential to significantly cut costs and time and protect patients.
 
While drug counterfeiting poses a serious public health issue, there are very few studies that have assessed the effectiveness of various interventions to combat the problem. Future research should address the methodological limitations of existing studies, develop reliable data collection tools and determine the effectiveness of different systems in preventing the sale of counterfeit drugs.
 
RFID system
 
RFID technology has huge potential to stop spurious and counterfeit drugs. This technology gives manufacturers the ability to track the entire supply chain of a prescription drug. It also provides information about expiration dates and stock levels of a drug. It can also be used to trace surgical equipment, medical devices, and other products. It can prevent the manufacture and distribution of counterfeit products and help pharmaceutical companies combat the escalating problem.
 
RFID technology can help pharmaceutical manufacturers reduce their costs and improve the safety of their products by ensuring traceability of every step in the supply chain. It can also reduce drug-related errors and improve pharmaceutical management. However, it must be integrated into the workflow of pharmaceutical companies and be interoperable with the RFID systems of their partners. This technology can also be costly to implement. Nevertheless, the pharmaceutical industry is slowly moving toward incorporating RFID technology.

Many experts believe that RFID technology is essential for the safety of pharmaceutical products. 

The RFID technology can be tagged to pharmaceutical packaging electronically and can be used to monitor pharmaceutical products and determine their authenticity. In addition to improving traceability, RFID systems can improve transportation and decrease mistakes at hospitals. Currently, the world's pharmaceutical industry estimates that between ten and fifteen percent of all drugs sold globally are counterfeited. This percentage increases in the developing world, especially in Asia, Africa, and Latin America. Counterfeit drugs have high potential to cause health problems, especially among children and pregnant women.
 
RFID technology can also be used to track commodities through the supply chain. The RFID tag can track a product from the manufacturer to distributors to the pharmacy. This technology can also prevent the entry of counterfeit products into legitimate commerce. RFID technology also provides encryption and an electronic pedigree, making it difficult for counterfeiters to access these products.
Related Reading:
  1. Top Ten Strategic Decision-Making Tools for Operational Excellence
  2. ​How to cut costs strategically using Kaizen
  3. Top 30 Continuous Improvement Tools
  4. Top 10 Change Management models

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Categories:  Operational Excellence | Life Sciences 

Keywords and Tags:
#continuousimprovement #OpEx #operationalexcellence #barcodes #RFID #QRcode  #stopcounterfeitdrugs #detectfakemeds #druganticounterfeiting #TrackAndTraceSystem #PharmaSupplyChain #spuriousdrug
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