The continued squeeze on funding for the US Food and Drug Administration is prompting the agency to shut down regional offices
and some field facilities as one way to make more efficient use of its limited resources. A streamlined inspection program
also will try to identify those drug manufacturing sites most in need of frequent oversight, while reducing inspections for
less risky facilities. Highly-trained inspectors will be able to assess modern manufacturing systems more efficiently, and
field staff will work more closely with FDA Center reviewers to better understand company quality control systems.
These changes in FDA inspection operations fit the agency's Pharmaceutical Quality in the 21st Century initiative, which encourages broader industry adoption of quality control and risk management methods that can better
assure quality drug production and distribution with less direct oversight by the agency. Instead of frequent, in-depth plant
inspections, FDA aims to initially verify a manufacturer's process control and quality system and followup periodically with
more efficient audits, commented FDA deputy commissioner Janet Woodcock. Under the "desired state" of pharmaceutical manufacturing,
regulators will use risk-based approaches to make regulatory decisions and further streamline the inspection process, she
explained at a March workshop on pharmaceutical quality initiatives co-sponsored by FDA, American Association of Pharmaceutical
Scientists (AAPS), and International Society of Pharmaceutical Engineers (ISPE).
The reorganization of FDA's Office of Regulatory Affairs (ORA) has been in the works for several months and now is nearing
implementation, according to Margaret Glavin, FDA associate commissioner for regulatory affairs. ORA is eliminating its regional
structure and closing seven of its 13 field laboratories, a move that has generated controversy since first announced last
December. The current plan is to "phase out" labs in Detroit, Denver, Kansas City, Philadelphia, San Francisco, San Juan (PR)
and Winchester (MA); laboratories will remain open and will be expanded in Atlanta, Seattle, Jamaica (NY), Cincinnati, Jefferson
(AR), and Irvine (CA).
This downsizing of ORA reflects cuts in budget and staff. FDA's field force has dropped from 4,000 in 2003 to some 3,400 today.
ORA inspected 2,411 drug facilities in the US and abroad last year, compared to more than 2,600 in the three previous years.
Similarly, the agency inspected 1,826 biologics facilities last year, down from about 2,000 in previous years.
FDA's budget proposal for 2008 allots much of ORA's budget increase to food oversight, relying on prescription drug user fees
to maintain the current level of drug manufacturing oversight. To bolster its resources, FDA has proposed a reinspection user
fee that would collect $23 million and add 100 field staffers to revisit manufacturing facilities cited for violations in
initial good manufacturing practices (GMP) inspections.
ORA's streamlining plan is scheduled to go into effect Oct 1, 2007, unless sidetracked by opposition, which is surfacing within
the agency as well as among manufacturers. In addition to nervous field staffers, industry fears more difficulty in contacting
field officials and getting answers to specific questions. And members of Congress have voiced opposition to closing FDA labs
at a time of increased public concern about food contamination and medical product safety.
NEW APPROACHES TO QUALITY ASSURANCE
FDA officials would like to shift the focus from counting the number of plant inspections to evaluating how well it can ensure
medical product quality and safety. This approach involves adopting efficient strategies for targeting inspections to more
high-risk operations likely to have the greatest impact on public health and safety. In addition to a "significant decline
in resources for inspections," noted David Horowitz, ORA deputy associate commissioner for compliance, more complex manufacturing
processes require more expertise to evaluate.
Moreover, FDA regulatory operations suffer from industry efforts to sidestep the rules, Horowitz commented at the pharmaceutical
quality workshop. Industry compliance with GMPs "is bad and getting worse," he said, noting that manufacturers are "studying
for the test"—correcting specific deficiencies but not investing in systems that can avoid problems and correct root causes.
Modern manufacturing and technological developments provide opportunities for both FDA and industry to establish quality-oriented
approaches, Horowitz added, and risk management can better focus and target regulatory and manufacturing activities to "get
the most bang for the buck."