Pharma serialization: managing the transformation
• Cognizant 20-20 Insights
Pharma Serialization: Managing the TransformationBy making the right investments in the right technology with the right business partner, the pharmaceuticals ecosystem can alleviate and hopefully eliminate the threat of counterfeit drugs to patient
safety and wellness.
Executive Summary
information on leveraging global best practices
The global pharmaceuticals industry faces
when implementing serialization. It covers:
problems of counterfeiting, theft, diversion and
• The need for serialization.
false returns to manufacturers. The World Health Organization (WHO) estimates counterfeit drugs
• Key challenges for implementation.
are approximately 1% of the supply in developed
• An implementation maturity model.
countries and 30% to 40% in developing coun-
• Our approach to serialization.
tries. Though the 1% figure seems small, it consists of millions of prescriptions in the U.S. alone.
Serialization regulations are in place today in Turkey, India, China, Brazil, Argentina and South
Pharmaceuticals companies and governments of
Korea; regulations are pending in the U.S., Canada
countries worldwide believe that counterfeiting
and the EU. Each nation, however, follows its own
by organized crime can be reduced significantly
guidelines/legislation — e.g., California's e-pedigree
by implementing product serialization. Serializa-
law, U.S. FDA's serialization guidelines, Turkey's
tion requires a comprehensive system to track
serialization guidelines, China's SFDA serialization
and trace the passage of prescription drugs
requirements, etc. — to curb counterfeiting and
through the entire supply chain. Every product
thus ensure patient safety. Despite differences
should be identified by a unique serial number in
in the countries' laws, each nation's regulations
addition to the origin, shelf life and batch number.
tend to be built around GS1 standards1 and are
This will allow the product's lifecycle to be traced
sufficiently similar. This means pharmaceuticals
from production, through distribution and finally
companies, generally, can develop one program
to dispensation to patients at the drugstore or
that meets all global requirements. Although the
GS1 format is the favored standard, International
Serialization needs careful assessment, diligent
Organization for Standardization (ISO), Internet
planning and swift implementation. This white
Engineering Task Force (IETF) and other compet-
paper offers pharmaceuticals companies critical
ing standards also apply to serialization.
cognizant 20-20 insights january 2013
Hierarchy of Benefits
• Current business processes are very labor-
intensive and, as a result, the price paid by the consumer for pharmaceuticals products is high.
• The high price of prescription drugs and the
relative ease of duplication and diversion make them a prime target for counterfeiters.
• Current and pending regulatory requirements
Supply Chain Synergies
mandate that manufacturers deploy track and
and Efficiencies
trace tools for product movement as well as utilize authentication tools to retain their com-petitiveness.
Serialization could result in economic benefits, as well as improved brand protection and consumer confidence in their medications.2
Anticounterfeiting
What Drives Serialization?
Serialization is not just about generating unique serial numbers for any saleable units, but also maintaning those identifications to provide
visibility and full traceability within the supply chain. It requires collaborative action from partners throughout the supply chain for accurate recording, tracking and managing of data as the
product moves from manufacturer to distributor to the dispensing point.
Why Serialization?
Serialization: Implementation Challenges
Serialization is fast becoming a necessity for
Managing and administering serialization is a
the pharmaceuticals industry (see Figure 2) as a
complex process that leads to additional cost if
result of the following factors:
not managed properly. Key operational challenges
• A highly complex distribution network from
manufacturer to consumer in which products
• Creation of unique serialization codes for
change hands as many as 10 times.
individual products during the production
• The authentication of the product at various
levels in the supply chain becomes very difficult without data sharing across the supply chain.
Factors Necessitating Product Serialization
Manufacturing of
inferior copies of a
• Loss in revenue.
genuine "branded"
• Loss in profit.
product labeled with
• Loss in brand equity.
the original brand
• Potential lawsuits.
cognizant 20-20 insights
• High-speed printing and verification of the
The serialization system is expected to perform
codes generated.
the following higher-level workflows:
> Production rates up to 500 units per min-
• Organizing and managing serial numbers for
ute, as well as dust- and vibration-prone
the entire system.
packaging lines makes printing and verifi-cation challenging.
• Ensuring number uniqueness and randomness
via integrated algorithms.
Cross-site coordination for serial generation for similar product lines.
• Assigning the numbers to a batch.
• Integration with enterprise systems.
• Passing serial numbers on to the serialization
line system (SLS) for further processing.
Optimum utilization of existing technologies/machineries.
• Maximizing the use of serialization assets that
are required by most geographies.
The packaging line must be revalidated as equipment is added to generate each bar code.
• Ensuring that all serialization systems use
Each code must be linked to product data and
common capabilities: product identifica-
applied to packages to enable tracking throughout
tion equipment (PIE), product identification
the supply chain. And, last:
middleware management systems (PIMMS) and
electronic product code information systems
Change management: Employees must be
(EPCIS). All of these must be designed to
trained to handle the new equipment.
meet global standards and service all markets
Moreover, serialization demands that voluminous
("design once, use many").
data repositories are shared at all nodes of the pharmaceuticals supply chain. High data volumes,
Our serialization solution addresses the
accuracy, security and data reliability all add to
challenges at the shop floor and plant levels, and
the challenges of implementing serialization.
connects to the enterprise level. Our solution deploys units of unique identification ("serializa-
Serialization: Our View
tion") and creates associated unit-level electronic
We see product serialization as one of the top
records that can be easily accessed via the Web or
priority activities for pharmaceuticals and
smart phones in real time. Simple and ubiquitous
medical devices companies, as mandated by
access to product IDs (or UIDs) and related data
provide a previously unavailable level of visibility into the production, distribution and use of
Distributor Re-Packer Wholesaler Pharmacy Patient
12345678901234Ser No.
Common Equipment
Few Operating Models from
a Single IT& Data Model
GS1 Identification
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Carton Labeling and Association Process Flow
Electronic Product
Generation of Batch
Code Information Systems
E-codes for Product
Manage Association
Upload XML Files
Product Identification
oduct Line Co Middleware Management System
Associate Cartons
Associate Cartons
Associate Bundles
Associate Shippers
products or their components throughout the
• Evaluating current systems and processes
supply chain (see Figure 4).
for product serialization, by considering multiple factors such as functionality, technical
Our Methodology and Offerings
elements, interfacing and cost.
We advocate that pharmaceuticals companies
• Facilitating discussions on the future state "to
undertake an in-depth analysis of the current
be" for serialization and gathering high-level
scenario and consider multi-phase implementa-
tion of serialization (see Figure 5), which entails the following steps:
Serialization Blueprinting: Approach and Deliverables
Solution Blueprinting
and Implementation
• Gather and review
• Process and systems
• Review the processes • In this phase, a
existing documenta-
solution architecture
tion, work manuals.
• Interview/focus group
owners and look for
for serialization would
• Interaction with
meeting with key stake-
redundant activities,
be developed taking
stakeholders (various
unnecessary process
into consideration the
business functions
steps, role ambiguity,
various dimensions
• Identify current pain
and IT stakeholders
bottlenecks, cycle
points and challenges.
together) in an envi-
management require-
• Capture process
ments, packaging line
sioning workshop.
• Detailed analysis
handoffs between
considerations, line
Identify weaknesses
people and systems.
and product-specific
of the current docu-
Identify process and
tionality for packing,
technology opportuni-
warehouse and distri-
• A global master
ties for improvements.
bution operations.
blueprint template for
and outputs of the
product serialization
• Our SMEs develop a
high level of require-
is developed.
Select processes and
ments for the future
• Present final deliver-
packaging lines for
"to-be" in discussions
able and sign-offs.
in-depth study.
with all stakeholders.
• Present final deliver-
able and sign-off.
• Program overview.
• Process maps.
• High-level solution
• Workshop themes.
• Gap analysis document.
architecture/blueprint
to-be state.
Measures of success.
• High-level require-
• Project implementa-
tion roadmap.
• Individual creation/
validation of as-is processes.
cognizant 20-20 insights
Our Standard Framework
We have customized consulting, POC and
implementation/post-implementation support offerings for serialization, ePedigree, track and trace, product recall and
GS1 compliance requirements for pharma companies.
External Third-party, e.g.,
Tracelink , rfExcel
System Interfaces
SAP AIE/Other ERPs
PIMMS-PIE, EPCIS-PIMMS,
EPCIS-External (including pedigree)
Mobile Operations
• Functionality is not a key differentiator — all vendors
comply with the same international standard.
• All major pharmaceuticals companies are moving
to the same SAP modules for their business process.
• Providing a high-level solution architecture,
requirements documentation and roadmap for
Threats to the integrity of the drug supply are
implementation (see Figure 6).
likely to intensify in coming years. According to
Implementation Maturity Model
Peter Pitts, director of the Center for Medicine
for Serialization
in the Public Interest, global drug counterfeiting
Figure 7 depicts a model that we believe will help
is growing at 12% to 16% a year, and, in 2010,
in identifying an organization's degree of maturity
generated as much as $75 billion in worldwide
for a successful serialization implementation.
revenues. "It is shocking to realize that in some
Ascending Serialization's Learning Curve
Projects are managed
Projects are managed
A centrally managed
Central PMO with
End-to-end PMO from
at an individual level
at a unit level with
active management
blueprinting to global
and the synergies are
no centralized PMO.
defined processes
for site-specific
rollout with proactive
not exploited. Projects
Slightly consolidated,
and solutions, from
variations and scope
planning, detailed change
are managed as a
no consideration for
variations with clear
and risk management, best
discrete unit.
deployment across
practices and continuous
Configuration is
Data and packaging
Adaptable, flexible
configuration set-up
repeatable, but needs
line configurations
and line-specific
configurable serialization
that lacks flexibility and detailed study and
are well-defined and
configurations are
solution enabling support
design modification to
designed with elements captured at the
of wide variety of packaging
the code base.
that can be assembled
planning stage and
line functions.
and realigned to
global templates are
quickly accommodate
changing demands.
Solution deployment
Deployment plan is
Deployment plans
Global development
is planned for only
modified and installed
well-defined with all
support multiple
playbook is in place and
the pilot line with no
in similar packaging
serialization and
the solution is readily
replicable code base.
lines, but not readily
packaging-line-specific
coding requirements
installable, replicable and
repeatable and the
serialization variations
easily upgradable across
timelines are not
packaging lines and
cognizant 20-20 insights
Quick Take
E-code Serialization for a Pharma Major
We helped in implementing serialization for a • Managing and monitoring the change
leading global pharmaceutical major.
management plan.
• Managing IT risks and issues.
• Client wanted to implement e-code serialization • Providing regular status reports to IT
which uses common capabilities (PIE, PIMMS,
EPCIS) and is designed to meet global standards
Benefits Attained
and service all markets.
• Track-and-trace products deployed from the
• A complete solution was required to address
point of packaging to the pharmacy.
data management and packaging functions.
• Reduced the risk of counterfeit products being
• Ensuring client standards are met through
• Expired products now detected automatically.
engaging appropriate architecture, EIS and
• Performs product recalls more effectively and
quality resources at the right time.
• Engaging with other teams to deliver project
• Delivers the right product to the right patient.
parts of the world, somewhere between 30%
manufacturers can realize even greater benefits
and 50% of drugs to treat serious diseases are
such as total supply chain visibility and reduced
actually counterfeit," said Food and Drug Admin-
product recalls, over and above what is required
istration commissioner Margaret Hamburg,
by regulatory compliance.
who added that the problem "is growing every day."3 Meanwhile, Joe Ringwood, chief operating
Making the right investments in the right
officer of Systech International, noted: "Phar-
technology with the right business partner can
maceutical counterfeiting is a global problem
only help the pharmaceuticals ecosystem —
that is growing rapidly."4 As a result, serialization
manufacturers, wholesalers, distributors and
has the potential to be a very efficient tool for
pharmacies — alleviate and eventually eliminate
pharmaceuticals leaders in the fight against
the threat of counterfeited drugs to patient safety
and wellness. Successful serialization will be a key differentiator and a clear competitive advantage
Managing the transformation is a crucial and
for pharmaceuticals companies in the near term
essential part of the overall serialization imple-
and over the long haul as drug counterfeiting is
mentation strategy. By choosing a reliable partner
reduced to a distant memory.
and developing a diligent implementation plan,
cognizant 20-20 insights
Footnotes1 GS1 is the international standards group whose healthcare component is working on pharmaceuticals
product tagging standards. The GS1 system of standards is the most widely used supply-chain standards system in the world. It is composed of four key standards: barcodes (used to automatically identify items), eCom — electronic business messaging standards allowing automatic electronic transmission of data, global data synchronization standards (GDSN), which allow business partners to have consistent item data in their systems at the same time and EPCglobal which uses RFID technology for real-time item tracking. For more inf.
2 "Mass Serialization in the European Pharmaceuticals Market," Frost & Sullivan, page 23.
References• World Health Organization, "Medicines: Counterfeit Medicines," Fact sheet No. 275 (January 2010),
• Pharmaceuticals and Packaging News (PMP News), "Combating Counterfeits," Sept. 9, 2011, available
• Center of Medicines in the Public Interest, "Counterfeit Drugs and China NEW," available at
• Pharmaceuticals and Packaging News (PMP News), "Best Practices in Serialization," June 18, 2009,
• GS1 Healthcare Reference book 2011/2
• Life Science leader "The Long Road to Serialization and Track and Trace," March 27, 2
• Life Science Leader "Planning Serialization for Pharmaceuticals Manufacturer":
• EFPIA "Coding and Identification of Products: Towards Safer Medicines Supply":
Other Useful Links• • • • •
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About the AuthorsAravindhan Ramakrishnan is a Senior Consultant within Cognizant Business Consulting. He has extensive experience across life sciences, energy and consumer goods industries. As an operations and technology expert Aravindhan has been working with clients to help them transform their businesses. He focuses on strategy development and implementation, technology strategy, organization design, operational excellence and innovation management. Prior to Cognizant, Aravindhan was employed by IBM's Strategy & Transformation Practice and by Honeywell. He holds a bachelor's degree in engineering and an M.B.A. Aravindhan can be reached at
Ghazala Yasmin is a Consultant within Cognizant Business Consulting. She has over one year of experience in management consulting and business development, and has supported projects across various industries: life sciences, chemicals and consumer goods. She holds a bachelor's degree in chemical engi-neering and an M.B.A. from NITIE, Mumbai. Ghazala can be re.
About CognizantCognizant (NASDAQ: CTSH) is a leading provider of information technology, consulting, and business process out-sourcing services, dedicated to helping the world's leading companies build stronger businesses. Headquartered in Teaneck, New Jersey (U.S.), Cognizant combines a passion for client satisfaction, technology innovation, deep industry and business process expertise, and a global, collaborative workforce that embodies the future of work. With over 50 delivery centers worldwide and approximately 150,400 employees as of September 30, 2012, Cognizant is a member of the NASDAQ-100, the S&P 500, the Forbes Global 2000, and the Fortune 500 and is ranked among the top performing and fastest growing companies in the world. Vollow us on Twitter: Cognizant.
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Weng. Acute Bacterial Conjunctivitis Rebecca Weng BOptom Brien Holden Vision Institute Acute Bacterial Conjunctivitis ABSTRACT Acute bacterial conjunctivitis is encountered frequently in optometric practice. The condition often resolves on its own without any treatment. Although it is a self-limiting condition, current initial treatment for bacterial conjunctivitis is the application of a broad-spectrum topical antibiotic. While the use of antibiotics is associated with improved rates of early clinical remission, and early and late microbiological remission; its benefit in improving clinical outcome remains minimal. When prescribing antibiotics, clinician should ensure better patient compliance to minimise the growth of drug resistance. This report describes a patient who had been diagnosed with bacterial conjunctivitis, whose condition remained unresponsive when both chloramphenicol and tobramycin were prescribed. Different types of antibiotics and their modes of action are discussed. Possible drug adverse reactions are also included.
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