Temperature Indicators for Vaccines. ShockWatch Cold Chain Solutions TrekView Multi-use recorder...
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Temperature Indicators for Vaccines
Temperature Indicators for Vaccines. ShockWatch Cold Chain Solutions TrekView Multi-use recorder Performance Data Recorders Chemical Indicators ColdMark
ShockWatch Cold Chain Solutions TrekView Multi-use recorder
Performance Data Recorders Chemical Indicators ColdMark 2 WarmMark
2 Single use Low cost Go No/Go Price Increasing Value to Customer
ColdMark WarmMark ColdMark WarmMark Intelligent Monitoring System
Real-time Monitoring
Slide 3
Complexity of the Vaccine Supply Chain
Slide 4
AIR CARGO -20 o C OVER THE ROAD 43 o C WAITING ON THE TARMAC 32
o C OCEAN FREIGHT 43 o C Extreme Temperatures in the Supply
Chain
Slide 5
Vaccine Supply Chain Manufacturers are focused on the
production of safe and effective vaccines When product leaves the
manufacturer, there is a loss of visibility and control over its
safety and efficacy Quality agreements are required for the
hand-off points in the supply chain Manufacturers name is on the
line even after product leaves their facility Wholesalers must
abide by quality agreements established with manufacturers but not
governed by the FDA Frequently reuse packaging materials Work on
very low margins
Slide 6
Critical Control Points Manufacturing Site Short-term storage
Packaging design Transportation modes Third-Party Logistics Vehicle
qualification Transportation modes Handling Wholesaler Storage
Coolers Effects of opening and closing the refrigerator door
Repackaging / Reuse of packaging Transportation modes Handling
Slide 7
Critical Control Points Last mile transportation Vehicle
qualification Transportation modes Packaging Handling Doctors
office / Hospital Storage coolers Handling
Slide 8
Vaccine Last Mile Last mile is the most challenging Not always
known if temperature control has been maintained in the previous
supply chain segments Vaccine clinics, doctors offices are not
always equipped to maintain appropriate temperature control US
Department of Health & Human Services Office of the Inspector
General reported that approximately 44,000 doctors offices and
clinics participating in the Vaccines for Children Program (VFC)
did not store vaccines at suitable temperatures
Slide 9
Last Mile Concerns 3 in 5 surveyed physicians are "very
concerned" that cold chain breaches will compromise the efficacy of
the drugs they prescribe More than 50% cite concerns about serious
adverse effects due to poor cold chain management Harris
Interactive survey finds that more than 83% of primary care doctors
report experiencing a cold chain break Specialist doctors report
more cold chain breaks during product delivery as products reach
their offices Primary care doctors and pediatricians, on the other
hand, report more storage-related cold chain breaks for products
stored in their offices Source:
http://www.fiercepharmamanufacturing.com/story/mds-voice-concerns-over-cold-chain-breaches-effects-drugs/2010-06-22#ixzz2ZAogxvjKhttp://www.fiercepharmamanufacturing.com/story/mds-voice-concerns-over-cold-chain-breaches-effects-drugs/2010-06-22#ixzz2ZAogxvjK
Slide 10
Solutions to Cold Chain Concerns
Slide 11
Validation vs. Monitoring Validation is used to demonstrate
that the appropriate equipment and processes are in place to
maintain temperature control What happens in the real world? People
are in a rush Handing errors occur Packaging / coolers are damaged
Equipment failures occur Validation is a great starting point, but
it does not eliminate the need to monitor
Slide 12
Why Use Temperature Indicators? Vaccine shipments can exceed
1000 shipments per day Packaging usually validated for large
quantities Low cost temperature indicators used as back up in
validated packaging Low volume shipments from bio-techs &
clinical trials Recorders / indicators in shipments for
non-validated shippers Recorders / indicators for
temperature-controlled transport vehicles Provides the ability to
make important decisions on whether to use or discard vaccines
Provides the ability to make important decisions on which vaccines
should be used first
Slide 13
Benefits Quality Control Temperature-damaged vaccines
unknowingly delivered to patients Allows developing country users
to safely administer vaccines, despite potential cold chain
interruption Cost Savings Good vaccines thrown out due to lack of
knowledge about actual exposure (or lack of exposure) Helps to
facilitate the creation of new policies on handling of multi-dose
vaccines WHO estimates that the use of temperature indicators could
reduce wastage rates by up to 30% Source: Frost, Laura J., and
Michael R. Reich. Access: How do good health technologies get to
poor people in poor countries?. Harvard Center for Population and
Development Studies, 2008. Easy Decision Making Users can quickly
tell which vaccines are safe for use
Slide 14
WarmMark 2 and ColdMark 2
Slide 15
WarmMark 2 & ColdMark 2 Single-use, single temperature
threshold indicators Field-armable Easy-to-read with a definitive
color change Accurate & affordable Identifies out-of-tolerance
temperature conditions
Slide 16
How WarmMark 2 Works Patented process diffuses a blue liquid
across the window in the label in a controlled and repeatable way -
which means it can be used to measure the length of time since
activation. Inactive: liquid in blister, awaiting activation Armed:
blister squeezed, ON in Indication window lets you know the
WarmMark 2 is now active Activated: after exposure to temperatures
above the threshold, the blue dye will progress over time through
the indication window and can be read against the printed time
scale Stopped: progression of dye will stop when temperature drops
below threshold
Slide 17
How ColdMark 2 Works Patented activation allows ColdMark 2 to
be armed prior to use. With a below- temperature threshold event,
the indicator will turn red allowing you to know you had a cold
chain breach. Inactive: liquid in blister, awaiting activation
Armed: blister squeezed, RED in Indication window lets you know the
ColdMark 2 is armed Activated: after exposure to temperatures below
the threshold temperature for 30 minutes or less, red dye will
appear in indication window
Slide 18
Cold Chain Complete Combines WarmMark 2 and ColdMark 2 products
into a single package Monitors for out-of- refrigeration conditions
Available in four variations: 0C 8 C 0C 10 C 2C 8 C 2C 10 C
Slide 19
Return on Investment Example Costs not captured that may be
reduced with monitoring program: Administration feesAudits /
Regulatory Fines Replacement logisticsPotential Litigation
Slide 20
Quality and the Validation Process
Slide 21
Quality Product WarmMark 2 and ColdMark 2 are subjected to
rigid quality processes Certificate of conformance sent with every
shipment Release documents available upon request Internal
validation processes in place 3 rd -party validation conducted
Slide 22
How to Use
Slide 23
Slide 24
Slide 25
Slide 26
Product Demos
Slide 27
WarmMark2 Demo
Slide 28
ColdMark2 Demo
Slide 29
Internal Training Note: These slides are to help Sales and
distributors better understand the market. They can be integrated
into a customer presentation where appropriate.
Slide 30
Vaccine Cold Chain Overview
Slide 31
Misconceptions About the Vaccine Cold Chain The following
statements are NOT accurate: Vaccines are robust products that can
tolerate heat and cold Vaccines are free or inexpensive Warming
vaccines is more harmful than freezing them Vaccines that have been
frozen always look frozen, solid or changed Vaccine refrigerators
look after themselves Refrigerators storing vaccines require a low
level of maintenance During refrigerated transit or storage, if the
thermometer shows a temperature outside +2C to + 8C, there must be
something wrong with the thermometer The temperature throughout a
refrigerator is the same Refrigerators cannot reach freezing
temperatures Cold chain management is someone elses
responsibility
Slide 32
Drivers for Ensuring an Effective Cold Chain Source:
http://coolchain.org/cool-logistics-for-pharma-healthcare-surveyhttp://coolchain.org/cool-logistics-for-pharma-healthcare-survey
Over 300 pharmaceutical executives responded to a survey in
September 2012 and prioritized their cold chain drivers
Slide 33
Regulations United States Pharmacopeia (USP) 1079 sets the
standards for storage and distribution practices of healthcare
products in the United States and is recognized by many countries
around the world World Health Organization (WHO) issued QAS/4.068
on Good Distribution Practices in order to ensure the integrity of
pharmaceutical products during the distribution process Parenteral
Drug Association (PDA) published cold chain guidance reports
Technical Report 39 Guidance for Temperature-Controlled Medicinal
Products, Maintaining the Quality of Temperature- Sensitive
Medicinal Products through the Transportation Environment Technical
Report 46 Last Mile: Guidance for Good Distribution Practices for
Pharmaceutical Products to the End User Country-Specific
Regulations Many countries have specific regulations / guidelines
that govern maintenance of the cold chain
Slide 34
Vaccine Development 335 new infectious diseases emerged between
1940 and 2005 Typical development time for new therapy is 10 15
years with an average development cost of more than $1.2B
Temperature Control of Vaccines By 2015, 8 of 10 global
pharmaceutical products will require 2 8C storage & handling
Effective cold chain practices are needed to maintain the efficacy
of vaccines
Slide 37
Is there a need for monitoring? Is the product
temperature-sensitive? What are the thresholds? Will multiple
temperature products be shipped together? How many indicators are
needed? How long will the indicator need to work? What is the
ambient temperature at the time the indicator / recorder is
installed? Will the package be opened / repackaged? What is the
ambient temperature when the indicator is read? What else needs to
be considered?
Slide 38
Unit Level Or Case Level Monitoring WM 2 measures the
cumulative time exposure above a selected threshold Need to develop
some guidance on monitoring on the unit or case level
Slide 39
WarmMark 2 Benefits Accuracy Temperature accuracy of +1C No
false activations from human handling Quality Certificate of
conformance with every shipment Heat-sealed to prevent bleeding
Tamperproof Release documents available upon request Easy to Read
and Use Field-armable The word ON appears when device armed
Traceability Unique identifiers assist tracking Product is
lot-traceable
Slide 40
ColdMark 2 Benefits Accuracy Temperature accuracy of +1C
Accurate response time Quality Certificate of conformance with
every shipment Tamperproof Release documents available upon request
Easy to Read and Use Field-armable - requires no special packaging
or overnight shipping Window on device shows it has been armed
Traceability Unique identifiers assist tracking Product is
lot-traceable