Felicity Thomas is Associate Editorial Director of Pharmaceutical Technology, Pharmaceutical Technology Europe, BioPharm International.

Felicity Thomas

For some time now, the bio/pharmaceutical industry has been under increasing pressure to deliver efficient therapeutic products at pace and reduced costs. Global factors, such as the COVID-19 pandemic, rising rates of inflation, geopolitics, and novel therapeutic modalities, are compounding industry pressures and leading companies to renew their focus on operational strategies (1).

Faster speed-to-market, lower operational costs, improved product quality consistency, and better process control are just some of the key benefits that can be provided to the bio/pharmaceutical industry through process intensification (2). However, despite there being considerable research in certain fields where continuous processes have been implemented, there is limited information on end-to-end continuous systems, perhaps as a result of the separation between synthetic and formulation sections (3).

When approaching drug development via intensified/continuous processes, there are some important formulation considerations to take into account, such as the particle characteristics of both the API and the excipients, confirms Thomas Durig, senior R&D director, Life Sciences, Ashland. “Continuous manufacturing relies on automated, mechanical, gravimetric feeding to dispense the right proportions of the various components. Powder ‘feedability’ and flowability are therefore paramount,” he says. “Particle characteristics such as size, shape, bulk density, surface area, cohesiveness, electrostatic charging tendency, surface roughness, stickiness, and hygroscopicity can all affect successful continuous manufacturing.”

Additional care should be taken over determining whether the drug can be formulated using excipients that allow for direct compression or roller compaction (dry granulation), which are the current best-established continuous processes for oral solid dosage forms, emphasizes Durig. “If wet granulation is required, one must consider the rate limiting and potentially destabilizing step of drying the granulation, so a further consideration would be whether the product could be produced via melt granulation (i.e., twin screw hot melt extrusion), this can obviate these limitations of wet granulation. There are a lot of advances being made in this aspect by leading companies and academic institutions,” he notes.

“Process intensification and continuous unit operations are fast becoming the new normal in biologics manufacturing, as they enhance productivity through the efficient use of production suites,” adds Paresh Vadgama, fellow scientist, Biologics Product Development, Catalent. “Though the biopharmaceutical industry has successfully implemented processes for drug substance (DS), its application for drug product manufacturing is still nascent. Biologics, being complex and highly sensitive molecules, have selected excipients added to protect them against various environmental factors during production and transportation,” he says.

Other than considering the molecular stability and drug product presentation needs, Vadgama notes that understanding of other factors, such as the DS dilution ratio, product compatibility with contact parts, and risk of exposure to environmental factors, is also required. “In addition, specific dosage form needs, including particle size and its distribution for suspension, or residual moisture for lyophilized powder, as well as stability-indicative analytical methods for real-time quality monitoring, should also be considered,” he states.

There are many formulation challenges that pertain to intensified processes, Vadgama continues. “One main issue to consider is the risk of a high titer or a high density/intensified fed-batch producing concentrated solutions,” he explains. “Such solutions may be too viscous to handle during filtration and filling operations. Moreover, these circumstances offer the potential for aggregation due to the absence of a stabilizer. Amino acids, such as arginine hydrochloride, or salts, including sodium chloride, can be added at the upstream stages of bioprocessing to protect protein molecules.”

Monitoring the attributes of a product in real-time during continuous process control and product quality monitoring has always been challenging, Vadgama stresses. “However, performing at-line rapid analysis using standard techniques of multiple sterile samples collected along the process flow, could potentially resolve such challenges,” he states.

Moving to downstream processes and the aggregation risk of shear-sensitive molecules can be problematic as this makes them difficult to handle in high-speed filling machines, Vadgama adds. “Optimizing stabilizer and/or surfactant ratio during formulation development can help to reduce the negative impact of mechanical interfacial stresses,” he explains. “In addition, scale-down modeling using computational fluid dynamics can be best suited to studying molecular behavior while undergoing anticipated processing conditions.”

“Generating multiple drug product batches from a single drug substance batch in a continuous mode is also very difficult,” Vadgama emphasizes. “Factors such as diverse dosage forms, product batch size, and variable market forecasts play a significant role.”

To mitigate the risks posed by the aforementioned challenges without negatively impacting the microbiological quality, Vadgama points to a few different strategies, such as splitting the DS batch or diverting material and parallel product manufacturing in dedicated good manufacturing practice suites. “The key to success is to ensure end-to-end, detailed process and raw material movement mapping and synchronization between various teams,” he says.

“Some of the specific challenges [when formulating for intensified processes] are the need for ‘feedable’ excipients and the risk of variability that would render gravimetric feeding/dispensing and process control very tricky,” asserts Durig. “Potential solutions [to these challenges] include ensuring that the process can handle the inherent variability in powder characteristics that impact feedability, and choosing only formulation components in which the powder properties are optimized, well-understood, and controllable.”

Pointing to some examples of excipients that are optimized for continuous manufacturing, Durig highlights two options available from Ashland, Benecel DC HPMC (hypromellose)—an existing, approved excipient—and Polyplasdone Plus crospovidone—which is pending approval. “[These products] are important because they are surface-optimized excipients that also include glidant and lubricant,” he states. “These factors enable powder feeding of otherwise poorly flowable and controllable finely divided solids as well as good tablet compaction.”

Continuous tablet coating can also pose a challenge to formulators as a result of the drying/mass transfer of water in the formulation, which can take an order-of-magnitude longer than the other close-coupled process times, reveals Durig. “The consequence is that drying can be rate limiting,” he says.

Some possible solutions to help with continuous tablet coating issues include advanced coaters, such as the ConsiGma coating modules (GEA, Germany), or continuous coaters, such as KOCO (L.B. Bohle, Germany), adds Durig. “However, here too, process time limitations exist. These can be overcome with purposely designed ultra-high solids, ultra-high spreadability coating products such as Ashland’s Aquarius Genesis film coatings,” he says.

In June 2022, the US Center for Drug Evaluation and Research’s (CDER’s) Office of Pharmaceutical Quality (OPQ) published an article regarding the results of a self-audit that they performed about the regulatory approved products that had been manufactured using continuous processes versus those that had been batch manufactured (4). Specifically, confirms Ana Ladino, Global Regulatory Affairs director, Life Sciences, Ashland, the OPQ looked at the time to approval and market entry, manufacturing process changes reported in annual reports, manufacturing-related post-approval application supplements, and pre-approval inspections. Based on its self-audit, FDA concluded that continuous manufacturing technology has regulatory advantages and economic advantages, and that its use should be encouraged in the development and manufacture of drug substances, she notes.

Less than a year later, in March 2023, the International Council for Harmonisation (ICH) published the Step 5 version of its Q13 guidance on continuous manufacturing (5), which expands upon the guidance set out by FDA back in 2019 (6). “ICH’s Q13 guideline, soon to be effective in the EU [European Union], is the first step towards harmonizing scientific and regulatory principles covering batch definition, control strategy, process validation, and stability studies,” asserts Vadgama. “Key regulatory messages for continuous manufacturing from this guidance include: that the dossier should summarize process integration for each unit operation, along with input raw material attributes, feedforward, and feedback process controls; process dynamics should be well understood with respect to changing inputs or operational conditions or transient events, which in turn would require deeper formulation robustness studies; the mode of manufacturing can be converted from batch to continuous, with appropriate control strategies and comparability exercises, even after product approval; details of the real-time release testing model to measure protein content, residual moisture, and protein stability are to be provided as applicable.”

Improving speed of product development and reducing costs are the two main drivers for businesses to adopt intensified processes, Vadgama stresses. “However, the technology still needs to evolve for it to be suitable for broader implementation within the drug product space,” he says. “Several non-technical limitations may explain this phenomenon: for example, initially, high capital investment is required to automate equipment, innovate process analysis/control technologies, and standardize practices across sites. But increased productivity, higher facility utilization rates, and lower labor costs would, given time, drive production efficiencies and savings.”

When approaching continuous production as an integrated unit operation, there could be some impact on the organizational structures of the purification and formulation areas as the distinction between these facets will become blurred, Vadgama continues. “Such changes can alter working practices, due to transitioning from a batch production mindset,” he explains. “In the drive for process excellence, emphasis should be given to operational control and regulatory compliance; therefore, receiving the full support of top executives and management is vital.”

Focusing on the supply chain, it is important to note that continuous operations require an uninterrupted supply of raw materials of consistent quality, Vadgama adds. “Single-use, disposable components form the backbone of the supply chain for continuous manufacturing workflows,” he summarizes. “Diversifying supply, better long-term inventory planning, and quality assurance teams being able to thoroughly qualify vendors can help remove the risk of supply chain issues.”

“Industry and stakeholder perceptions regarding the risk of adopting newer state-of-the-art manufacturing technologies are obstacles that must be overcome,” warns Durig. “The pharma industry tends to be conservative about adopting new manufacturing and formulation technologies.” Using twin-screw melt granulation as an example, he points out that despite the advantages such a technique can offer when compared with wet granulation approaches to continuous manufacturing, perceptions still exist that the technology could have an adverse effect on API stability.

“These perceptions and the obstacles they present to new technology can be overcome through trial and investigation. Continued education and collaboration among industry stakeholders, drug product manufacturers, equipment manufacturers, excipient companies, and academia are required,” Durig concludes.

1. Dukart, H.; Lanoue, L.; Rezende, M.; Rutten, P. Emerging from Disruption: The Future of Pharma Operations Strategy. McKinsey and Company, Oct. 10, 2022.
2. Yazdanpanah, N. Continuous Manufacturing in the Pharmaceutical Industry. 

, March 2021.
3. Domokos, A.; Nagy, B.; Szilágyi, B.; Marosi, G.; Kristóf Nagy, Z. 

, 25 (4), 721–739.
4. FDA. An FDA Self-Audit of Continuous Manufacturing for Drug Products. 

, June 28, 2022.
5. EMA. EMA/CHMP/ICH/427817/2021 

ICH Guideline Q13 on Continuous Manufacturing of Drug Substances and Drug Products

. Step 5 version, March 3, 2023.
6. FDA. Quality Considerations for Continuous Manufacturing; Draft Guidance for Industry; Availability. 

Felicity Thomas is the European/senior editor for Pharmaceutical Technology Group.


Vol. 47, No. 4
April 2023
Pages: 24–26, 44

When referring to this article, please cite it as Thomas, F. Formulating Drugs for Continuous Processing. 

Articles

Despite the advantages intensified processes can offer developers, there are still some obstacles to overcome before broader application of new technologies will be implemented.

Formulating Drugs for Continuous Processing

The biopharmaceutical market is experiencing continued growth—forecast to reach $769.45 billion by 2030 (1)—driven by factors such as an aging population and the increasing prevalence of chronic diseases. Additionally, thanks to the ability of biopharmaceuticals to treat diseases that were once considered ‘untreatable,’ there is a greater acceptance of these therapies across the board within the industry.

Biopharmaceutical drugs, however, are intrinsically unstable and predisposed to degradation and may require processes that can maintain the product’s stability during storage and transport. “Protein-based biologics are susceptible to various stresses such as temperature excursions, pH shifts, shear, interfacial adsorption, moisture, organic solvents, and so on. Some biologics are less stable in their liquid state and may undergo hydrolysis, thereby, leading to protein aggregation and/or denaturation. Moreover, the storage and transport of bulk products in their liquid or frozen state increases the need for cold chain shipping requirements and validation,” confirms Ashutosh Sharma, researcher, Pharmaceutical and Molecular Biotechnology Research Centre, SETU Waterford (Formerly, Waterford Institute of Technology), Ireland. “To combat some of these challenges, freeze-drying of biologics is deemed suitable for many products.”

Freeze-drying, or lyophilization, of therapeutic products is a well-established technique within industry. The batch freeze-drying process is commonly used for a variety of biologics, such as enzymes, antibodies, fusion proteins, nanobodies, vaccines, hormones, and gene therapy products, according to Sharma. “Some advantages of freeze-drying include improved stability and shelf-life of labile biologics, reduced chemical decomposition and cold chain requirements, and low residual moisture content post-processing,” he says.

According to market research, the global market for lyophilization services for biopharmaceuticals is expected to grow at a compound annual rate of 10.1% between 2022 and 2030 (2). This growth is undoubtedly reflective of the increasing demand for biopharmaceuticals that is being witnessed by industry as a result of the therapies’ high specificity for treating widespread diseases, as well as their improved interactions with cellular receptors and other biomolecules, Sharma notes.

“Being high-value products, ensuring a high standard of safety, quality, and efficacy of [biopharmaceuticals] is of utmost importance,” says Sharma. “As per a review by Gervasi 

 (3), nearly 34% of biologic products are lyophilized formulations in the European market. Two key drivers for this technique are to improve and increase the shelf-life of biologic drug products and to reduce complexities associated with cold chain requirements of liquid and/or frozen bulk products while the technique itself has its own challenges.”

When freeze-drying drug products, there are several fill/finish unit operations in addition to lyophilization, such as freeze-thawing, time out of refrigeration, vial filling, and so on, that need to be considered which could potentially impact the products’ critical quality attributes (CQAs), Sharma stresses. However, focusing on conventional lyophilization, which is one of the major unit operations for freeze-dried products, there are a few key challenges that should be noted, he states.

“Firstly, long processing times that could vary from days to weeks with high capital costs and high energy consumption leading to reduced efficiency in the overall process [are a significant challenge],” Sharma says.

Then, there is the potential for some biologics to experience cold denaturation during the freeze-drying process, Sharma continues. “The requirement for appropriate formulation components including cryoprotectants and lyoprotectants as well as their impact on the overall glass transition temperature and melt temperature is very essential at the formulation development stage prior to lyophilization,” he says.

Other concerns pertain to the heat and mass transfer, as well as scaling up of the process—all of which are under discussion (4–6)—which can be dependent upon the dryer designer, container closure, load condition, and product formulation, Sharma emphasizes. “Vials situated on the edge of the shelves dry faster than vials present in the center due to radiation from the chamber walls which causes issues of vial-to-vial heterogeneity,” he says.

“Moreover, being a static process, [lyophilization] increases the risk of rejection of the entire batch in case of process failure. A batch process is limited to processing small volumes of unit doses which increases the requirement for a large number of vials,” Sharma specifies. “Human intervention during the process can increase the risk of contamination despite current good manufacturing practices (CGMP).”

Furthermore, Sharma points out that the reconstitution of certain high concentration freeze-dried protein cakes can prove problematic and lengthy when compared with free-flowing powders that are produced by alternative drying techniques.

And these challenges are also evolving in the wake of the continued advancement and increasing complexity of the biopharmaceutical therapies in development. “To meet the needs of patients, some biologic products are required in multiple dose strengths. Each dose strength requires a completely different lyophilization cycle with additional qualification and validation for different fill/finish unit operations, primary packaging components supply chain, sterilization and clean validation, container closure integrity, and so on, thereby, increasing the complexity of this technique for certain drug products,” Sharma states.

“To combat some of the challenges associated [with] conventional lyophilization, alternative drying technologies are gradually gaining popularity for the manufacturing of biopharmaceuticals,” asserts Sharma. By way of example, Sharma highlights some of the continuous processes and technologies that are currently under development, such as the Spin-freeze-drying of unit doses technology developed by RheaVita and Ghent University (7), or the continuous freeze-drying of suspended vials that has been developed and described in patent from 2018 (8).

Another alternative approach that has gained some interest within industry has been Electrostatic spray-drying developed by Fluid Air (9), which has the ability to improve drying efficiency with reduced thermal stress, Sharma continues. “Moreover, [aseptic] Spray-freeze-drying by IMA Life and Meridion Technologies (10) and PRINT Technology by Liquidia Corporation (11) are also promising technologies that enable particle engineering for the production of dry powder-based products,” he adds. Further innovative drying techniques have been detailed in a paper by Sharma 

“Along with some of the continuous and alternative drying technologies described above, process as well as product characterization are essential requirements as per CGMP,” Sharma says. “Product and process characterization can be achieved by using process analytical technologies (PATs) and offline characterization techniques. These technologies allow to identify and evaluate critical process parameters and CQAs and may also aid in establishing a correlation between the two.”

Numerous advanced techniques, including near infrared spectroscopy, Raman spectroscopy, infrared thermography, mass spectrometry, and wireless probes, have been evaluated as PAT tools for lyophilization and alternative drying technologies for biologics, Sharma explains. “In addition, other advanced characterization techniques such as solid-state hydrogen deuterium exchange–mass spectrometry and solid-state nuclear magnetic resonance provide more insights on protein-excipient interactions in the solid-state,” he states.

“Overall, these techniques will aid in improving the existing process by providing more insights and better understanding of both the process and the product,” Sharma concludes.

Biopharmaceutical Market by Product Type (Monoclonal Antibody, Interferons, Growth and Coagulation Factors, Recombinant Proteins, Hormones, Vaccines, Cell and Gene Therapies, and Others), by Therapeutic Application (Oncology, Immunology, Cardiovascular Diseases, Neurological Diseases, Metabolic Diseases, Blood Disorder, and Others), by End User (Hospital and Retail Pharmacies, Biopharma Companies, Diagnostic Labs, and Clinical Research Organizations)— Global Outlook and Forecast 2022–2030

. Market Report, Aug. 8, 2022.
2. InsightAce Analytic. 

Global Lyophilization Services for Biopharmaceuticals Market

. Market Report, Aug. 3, 2022.
3. Gervasi, V.; Dall Agnol, R.; Cullen, S.; McCoy, T.; Vucen, S.; Crean, A. Parenteral Protein Formulations: An Overview of Approved Products Within the European Union. 

, 131 (October), pp. 8–24.
4. Patel, S.M.; Pikal, M.J. Emerging Freeze-Drying Process Development and Scale-up Issues. 

, 12, 372–378.
5. Barresi, A.A.; Pisano, R.; Rasetto, V.; Fissore, D.; Marchisio, D.L. Model-Based Monitoring and Control of Industrial Freeze-Drying Processes: Effect of Batch Nonuniformity. 

, 28 (5), 577–590.
6. Sharma, A.; Khamar, D.; Cullen, S.; Hayden, A.; Hughes, H. Innovative Drying Technologies for Biopharmaceuticals. 

 (accessed Jan. 16, 2023).
8. Trout, B.L.; Pisano, R.; Capozzi, L.C. Freeze-Drying Methods and Related Products. WO2018204484A1, 2018.
9. Fluid Air. Electrostatic Spray Drying. 

www.fluidairinc.com/processes/spray-drying

 (accessed Jan. 16, 2023).
10. IMA. Continuous Aseptic Spray Freeze Drying. 

IMA.it/pharma/paper/continuous-aseptic-spray-freeze-drying/

 (accessed Jan. 16, 2023).
11. Liquidia. PRINT Technology. 

www.liquidia.com/products-and-pipeline/print-technology


Vol. 47, No. 4
April 2023
Pages: 32–34

When referring to this article, please cite it as Thomas, F. Accepting Alternative Approaches to Freeze Drying. 

Alternative approaches to freeze-drying are gaining popularity and will help to overcome some of the challenges associated with conventional lyophilization.

Accepting Alternative Approaches to Freeze Drying

As we enter the second quarter of 2023, the revised pharmaceutical legislation for Europe is still, at the time of writing, unpublished. The latest delay to the publication of the new pharma reform, which is the third postponement, came towards the end of March 2023, much to the dismay of members of the European Parliament (MEPs).

MEP and member of the Renew Europe Group, Véronique Trillet-Lenoir, urged the president of the European Commission in a letter issued shortly after the delayed publication was revealed to publish the legislation. In her letter, Trillet-Lenoir indicated that the commission has given into industrial pressure to further postpone the legislative revisions, and she stated that the lack of justification for the delay and the fact that no alternative date for publication has been provided is simply “unacceptable” (1).

“This legislation is key to ensure the fair and equitable access of medicines to all patients, to all Europeans,” she wrote (1). “Today, we are urging you [Ursula von der Leyen] to publish this important legislative package no later than April 2023 to allow the legislative process to start.”

However, there have been glimpses to what might be in store for industry as, at the end of January 2023, the internally circulated proposed reforms were leaked and were met with trepidation by industry. The European Federation of Pharmaceutical Industries and Associations (EFPIA) expressed particular concern about the leaked reforms, which it warned would “irretrievably sabotage” the European Union’s pharma industry (2).

“Whether it is naivety, blind optimism, or a more conscious decision for Europe to rely on innovation from the [United States] and Asia, there should be no doubt that in its current form, this proposed legislation will be extremely damaging to the competitiveness of Europe’s industry and to our region’s strategic autonomy,” specified Nathalie Moll, EFPIA director general, in the reaction press release. “It will have a negative impact on jobs, investment, the European research eco-system, growth, patient access to new clinical trials, and availability of the latest treatments for decades to come.”

With no defined date for publication of the EU’s pharma legislation reforms, the question now becomes whether or not these revisions can be appropriately reviewed before the 2024 European parliamentary elections.

1. Trillet-Lenoir, V. Twitter Post, @VTrillet_Lenoir, 23 March 2023.
2. EFPIA. EFPIA Reaction to Leak of the Proposed Pharmaceutical Legislation. 

When referring to this article, please cite it as Thomas, F. Legislative Hold-Up. 

A further setback to the publication of the pharmaceutical legislative changes in Europe may mean time is running out for appropriate review before 2024 parliamentary elections.

Legislative Hold-Up

In this episode of the Drug Solutions podcast, Felicity Thomas, European/Senior Editor, talks to Rhonda Henry, President of Emmes’ BioPharma Group, and Adam Mendizabal, VP and Director of Emmes’ Cell and Gene Therapy Center, about the role contract research organizations (CROs) play in cell and gene therapy development. Rhonda and Adam will discuss the key factors and solutions driving growth in the CRO market with a particular emphasis on cell and gene therapies entering development pipelines, and will address some of the challenges facing the industry and best practices to ensure these limitations are overcome.

Rhonda Henry is the President of Emmes’ BioPharma Group

. She holds a B.S. in nursing from the University of North Carolina, Wilmington. Rhonda joined Emmes with 30 years of clinical research experience holding a number of leadership positions in clinical operations, patient centricity and strategic partnerships at PPD.Before her entry into clinical research, Henry served as a nurse at New Hanover Regional Medical Center. In 2020, she was named to the PharmaVOICE 100 list of most inspiring people working in the life-sciences industry. She has been active in a number of non-profit organizations, including her current position as chair of the board of directors for The Carousel Center, a nationally accredited child advocacy center serving New Hanover, Brunswick, and Pender counties.

Adam Mendizabal, PhD is the VP and Director of Emmes’ Cell and Gene Therapy Center

. He joined Emmes in 2002 and has progressively increased responsibilities from a Biostatistician and Sr Investigator to his current role leading the expansion and of the cell and gene therapy clinical trial portfolio at Emmes. During his time at Emmes, Adam has co-authored publications across different therapeutic areas that have focused on cell and gene therapies. He received his Bachelor’s degree in Biological Sciences from Rutgers College in 2000, a Master’s degree in Statistics from Rutgers University in 2002, and a PhD in Epidemiology from The George Washington University in 2014.

 presents the Drug Solutions podcast, where the editors will chat with industry experts from across the pharmaceutical and biopharmaceutical supply chain. Join us as experts share insights into your biggest questions—from the technologies, to strategies, to regulations related to the development and manufacture of drug products.

Podcasts

In this episode, Rhonda Henry and Adam Mendizabal from Emmes discuss the role CROs play in cell and gene therapies undergoing clinical trials at all stages.

Drug Solutions Podcast: How CROs Adapt Themselves in the Ever-Changing Landscape of Cell and Gene Therapies

There are myriad factors influencing the drug delivery market, such as the rising prevalence of chronic conditions, an ageing population, and technological advancements in drug development, leading analysts to predict continued growth in the sector at a compound annual rate of 3.7% between 2022 and 2030 (1). A significant driver of growth within drug delivery has been highlighted as the advancement of the biopharmaceutical industry, which is giving rise to new and innovative drugs for previously untreatable or incurable diseases and, hence, the need for ways to deliver these novel therapies.

To learn more about influential drug delivery trends, market drivers, aspects of drug delivery that require greater research, and how partnering with an outsourcing company can help in this sector, 

® spoke with Torkel Gren, senior director, science and technology officer, and Uwe Hanenberg, head of product development, Oral Solid Dose, both at Recipharm.

 Over the past decade, what, in your opinion, have been the most influential developments in alternative drug delivery formulation?

 The most influential development in recent years has been the advance in solid lipid nanoparticles that allowed the development of mRNA [messenger RNA] vaccines to tackle COVID-19. [This advancement] opens up the opportunity to develop many new pharmaceutical products with increased efficacy in the future. There is plenty of potential to harness mRNA technology to create exciting new vaccines and other therapies to tackle previously untreatable conditions over the next decade.

 What trends in alternative drug delivery formulation do you think may be seen during the next decade?

 There will be increasing investment in new delivery technology for targeted and or simplified drug delivery. The effect/side effect ratio of a large number of drug substances can be significantly improved when delivered directly to the site of action. Administration by injection will play a key part here, alongside other delivery routes—topical, pulmonary, and ophthalmic, for example.

Integration of dosing with smart devices will also be a major theme in the coming decade as a means of increasing patient adherence. By monitoring biodata, such as blood glucose, these systems can provide both patient and HCP [healthcare professional] with valuable information to ensure that medication is used optimally to meet the unique needs of individual patients.

It is expected that the next decade will see advances allowing oral delivery of a greater number of biologic formulations. Efforts are already being made to develop a platform technology to support absorption of orally administered biopharma treatments, with exciting potential to further improve patient convenience.

 Could you elaborate on any of the market factors that are driving growth in the alternative drug delivery formulation sector?

 Rising demand for new biologics has created the need for special formulations for these treatments. It is important to note that the term ‘biologics’ refers to a large number of different modalities, from monoclonal antibodies, nucleotides, CAR-T [chimeric antigen receptor T] cells, and microbiome products. These all have their specific scientific challenges, each requiring a different formulation approach.

Interest in improved treatment for small indications has also contributed to greater demand for alternative drug delivery, as these often call for some special drug delivery solutions.

 How have these drivers changed over recent years?

 The trend toward more advanced biological treatments with a higher potential to cure the disease rather than just its symptoms has implications for drug delivery. Technologies that ensure an effective treatment by improving the stability of the active ingredient and that can be administered easily (e.g., orally) are drivers and will enhance patient compliance This could increase the demand for specialized drug delivery solutions in the coming years.

 Are there any areas in alternative drug delivery formulation approaches that still require a significant amount of research?

 [There have been] impressive developments in new biological medicines in recent years, with a number of new therapies entering the global market. However, the cost of these products has undermined their impact on public health and wellbeing. More work needs to be done to reduce development and manufacturing costs of these biopharma treatments while optimizing their efficacy.

New drug delivery technology may help solve this problem in the future. Better formulation approaches, for example, have the potential to improve stability, resulting in longer shelf life and reduced need for cold storage. This can cut distribution costs significantly, especially in countries with warm climates and limited infrastructure. Currently, biologics that have exceeded their shelf life or been transported outside their allowed temperature interval have to be disposed of—which is also very costly.

The fact that most biologics today need to be administered by injection is also contributing to their relatively high overall treatment cost, as this usually means they must be administered to patients by HCPs. There is some interesting work on alternative administration routes (orals, buccal, and pulmonary, for example), but it is likely that injection will continue to dominate in the future, due to the unique stability and absorption characteristics of biopharma. Injectable delivery systems, such as auto-injectors, which allow self-administration by the patient in the home, can help reduce costs by eliminating the need for a trip to a clinic to be treated by a HCP. Depot formulations allowing monthly dosing instead of daily injection can also reduce the burden on HCPs and clinics.

 What is the role of an outsourcing partner in the alternative drug delivery formulation market?

 Many different types of drug delivery technologies will be needed for different modalities, administration routes, and markets. As such, it is almost impossible for pharmaceutical companies to fill all their needs in-house. Outsourcing drug development and manufacturing to contract development and manufacturing organization partners can address this issue. By working with partners that have experience in a particular alternative technology, companies can benefit from specialist expertise and infrastructure, helping to smooth their development journey.

Pharmaceutical Drug Delivery Market (by Route of Administration: Oral, Pulmonary, Ocular, Nasal, Injectable, Topical, and Others; by Application: Cardiovascular, Diabetes, Cancer, Infectious Diseases, and Others; by End Users: Hospitals, Ambulatory Services, and Home Healthcare)—Global Industry Analysis, Size, Share, Growth, Trends, Regional Outlook, and Forecast 2021–2030


Vol. 35, No. 3
March 2023
Pages: 14–15

When referring to this article, please cite it as Thomas, F. Influencing Change in Drug Delivery. 

Advancements in therapeutic modalities are necessitating change in drug delivery to help negate some of the expense of development and manufacturing.

Influencing Change in Drug Delivery

The global pharmaceutical supply chain has been under unprecedented stress for a number of years, with events such as the COVID-19 pandemic and the war in Ukraine causing major disruptions, further heightened by surging winter sickness. Within Europe, region-wide measures have been put in place to try to mitigate issues arising from medicines shortages. For example, the European Commission has been stockpiling drugs and demanding that manufacturers guarantee supplies (1).

To find out more about the supply chain challenges impacting Europe, how companies can overcome associated difficulties, what potential trends might happen in the near future, and ways to future-proof supply chains, 

® spoke with Richard Ettl, CEO of SkyCell—a Swiss-based logistical solutions provider.

 Could you provide a brief overview of the current state of European pharmaceutical supply chains, highlighting any major issues causing difficulties for companies in the region?

 In Europe, countries such as Germany, France, and Italy are running short of even simple pharmaceutical products like antibiotics, painkillers, and antipyretics. This supply issue is something that developed countries have not experienced in the last few decades. As pharmaceutical products are usually produced at various different sites and locations to ensure a consistent supply, even if production at one site is interrupted, there is usually little to no effect to the consumer.

The root cause of current stock issues comes down to lean supply chains in good times getting into trouble very quickly when there are multiple sustained disruptions globally. The core disruption we are currently seeing is due to challenges in the production and logistics of products along the pharma value chain.

Prolonged lockdowns in countries like China and India that are largely responsible for the raw material supply of pharma products is now having a whiplash effect. Intermediary stocks meant that it took a while for severe disruption to appear, but as critical supplies have now fallen dangerously low in stock, a delayed effect from the COVID-19 pandemic is starting to be felt around the world.

 How can industry adapt to the evolution of the European pharma supply chain?

 Generally speaking, countries are becoming more accepting of superior margins and associated costs in the pharma industry to continue to fund the R&D of new drugs, and also of the costs required to ensure the continuous supply of pharma products. The recent stockouts are attracting the attention of regulators to investigate shortcomings in the system. Previously, there has been an overreliance on ‘fast and cheap’ when it comes to pharma production. Now, best-in-class pharma companies are focusing on reliability and resilience in the supply chain—if they can’t make a product or deliver a product on time, a patient is not served, and no sale is made.

However, pharma supply chains continue to grow even more complex as products are harder to make and require more stringent protection and transportation methods. And, at the same time, supply chains are becoming more unreliable.

Global businesses are entering what some are calling the ‘VUCA’ world—volatility, uncertainty, complexity, and ambiguity—a concept derived from the military and now being applied across many industries including pharma. Pharma companies are adjusting well after COVID-19, but the new normal is not yet what it was prior to the pandemic. The pharma industry is still not enjoying the high logistics reliability, low shipping costs, and high predictability of demand and supply from previous years.

The answer to uncertainty, however, is visibility and automation. Many problems in supply chains can be dealt with or even avoided with the right information—IoT [Internet of Things] provides visibility along the supply chain, in close to real time. Yet, information is only half the equation, action is what makes the difference. Some have reacted by building or contracting supply chain control towers, but the highest value can be gained by automating through software. People can scale to a certain degree but scaling by a factor of 100 is not possible with people in a short period of time and does not deliver on economies of scale. It is in these areas where companies should be placing greater attention.

 Are there any potential trends that will be impactful on the European pharma supply chain over the next five to 10 years?

 Looking ahead, new technologies or the evolution of technology will make the lives of supply chain teams easier, faster, and more cost efficient. Machine learning will help businesses that have automated their supply chains and can execute changes faster.

Sustainability will also become a key issue as most pharma companies are not focused on their CO

 footprint from scope 3 emissions. It is estimated that more than 80% of pharma companies’ CO

 footprint is in scope 3, which includes the delivery of its products to patients (2). If this is not being considered, then we are missing a huge amount of emissions that can make supply chains more sustainable and reduce the CO

Today, 70% of pharmaceutical products are shipped internationally in one-way shipping solutions. These are incinerated or sent to landfill in the vast majority of cases. This has not gone unnoticed by governments and investors.

The early movers here are the European Union, and island countries in APAC [Asia-Pacific] such as Japan. Governments are working on landfill fees that will go to hundreds of euros which will make one-way solutions more expensive than reusable systems. This will drive up the quality of reusable solutions and fewer products will be lost along the supply chain.

Pharma companies are also issuing ‘green bonds’ where investors can expect the contribution of capital to improve the company’s sustainability. The cost to ‘go green’ is usually massively overestimated—or in simple words, lower than everyone thinks. The World Economic Forum has worked with the Boston Consulting Group and McKinsey to find what the costs are to go green for the consumer (3,4). They found that there would only be a 1–4% price increase for the average product. For pharma companies, our estimate around €0.6 or 3% increase on a €20 vaccine vial, or 0.01% of a cancer drug costing €12,000 per treatment.

 What preparations should be made or put in place to ensure future readiness for any potential crises that may occur in the coming years?

 The next level is to combine visibility, automation, and simulation. At SkyCell, for example, this combination is called S+O [simulated and operational] data, when operational data—IoT, logistics milestones are overlaid with simulated data—where something is and should be. More importantly it is about what the risks will be, options and solutions going forward at that moment in time as real life is usually different from the planned version.

Imagine you are driving to see family in a different city and a tunnel is blocked by an accident, the earlier you have the information, the better the alternative plans that will be. On top of that, imagine a system that alerts you the evening before that there will be a lot of traffic and also adds a one-hour safety margin—this is simulation data.

By combining S+O data, supply chains can cope with disruption. Put simply, without effectively managing the supply chain, products would not reach patients.

1. Bounds, A. and Varvitsioti, E. EU Draws Up Plans to Stockpile Scarce Medicines. 

, 12 Jan. 2023.
2. My Green Lab and Urgentem. The Carbon Impact of Biotech and Pharma: A Roadmap to 1.5 °C. 

, October 2021.
3. World Economic Forum and Boston Consulting Group. Winning in Green Markets: Scaling Products for a Net Zero World. 

, Whitepaper, 12 Jan. 2023.
4. Broom, D. What’s the price of a green economy? An Extra $3.5 Trillion a Year. 


Vol. 35, No. 3
March 2023
Pages: 25–26

When referring to this article, please cite it as Thomas, F. Keeping Europe’s Medicines Stocked. 

Technological advances will help ease pressure on pharma supply chains, allowing for greater visibility and less uncertainty.