James Neal-Kababick Director, Flora Research Laboratories Adjunct Faculty, Bastyr University Botanical Medicine Dept Fellow AOAC International ©2012 Flora Research Laboratories 1 Warning: The Speaker Comes from a State that Allows Dogs to Drive You should keep this in mind when considering his advice. ©2012 Flora Research Laboratories 2 DISCLAIMER This presentation is not a substitute for qualified legal advice from competent, expert counsel Information provided is based on a variety of resources including speakers experience, FDA guidance documents, cGMP’s and regulatory actions- due to the dynamic nature of the industry, changes may occur rendering some of this information inaccurate Names of companies or case histories are for educational use only and are neither an endorsement nor a condemnation of said entities ©2012 Flora Research Laboratories 3 Changes and More Changes The industry many of us grew up with has changed dramatically in the last twenty years Changes continue to accelerate at a greater pace as the industry continues to mature Basing decisions on the “good old days” is likely to result in arrest, inventory seizure, class action suits, and large fines not to mention negative media attention to your company To address the dynamic market, FRL developed & utilizes Phytoforensic Science to help protect clients ©2012 Flora Research Laboratories 4 Phytoforensic Science The application of various techniques from microscopy to mass spectroscopy to protect the global food supply chain A special emphasis on dietary supplements Application of novel and “outside the box” approaches to problem solving Bringing together data from various instruments to see the “big picture” and solve the problem at hand Resolution of confusion through sound science ©2012 Flora Research Laboratories 5 Private Label-Risk Free? Utilizing a CMO to manufacture your products does not relieve you of any compliance requirements under 21CFR part 111 FDA warning letters make this point painfully clear Every CMO, contract testing lab, regulatory affairs consultant, distributor, packer, fulfillment service and shipper is considered an extension of your company You are liable for all of their actions under the cGMP’s as if they were parts of your internal organization That means that… ©2012 Flora Research Laboratories 6 Private Label – High Risk! If ANYTHING is out of compliance with 21CFR part 111 with ANY aspect of your CMO’s manufacturing chain in respect to your products that you are responsible under the cGMP’s! If ANY product manufactured by your CMO for ANY company is declared misbranded and or adulterated, the FDA can declare all products made by the CMO misbranded/adulterated and subject to recall REGARDLESS of whether or not your product was manufactured in compliance with 21CFR part 111! ©2012 Flora Research Laboratories 7 Private Label-CMO Issues This isn’t my beautiful industry. What happened here? ©2012 Flora Research Laboratories So now you have to worry about what your CMO is doing with other companies in the same facility that your product is made in. AND Worry about your products, about your CMO and about everyone else's products made by your CMO! SO MAYBE IT’S Time for some chamomile tea (or maybe a chamomile IV ) 8 Is There Hope? Should we just drink the Kool-Aid now or is there hope to survive in such a highly regulated industry? Consider this- The State of Utah’s largest industry is now the dietary supplements industry over all others topping $7 billion USD annually. Now about 60% of MD’s are using and recommending supplements to their patients up from <10% in 1997 The idea of a highly regulated industry, an agency with teeth and strong science & research add to consumer and practitioner confidence = more sales ©2012 Flora Research Laboratories 9 Why? Why would this be so? The “pass the buck” parachute loop was closed by these regulations The FDA went through all of this with the pharma OTC industry – they know all the tricks Study the Barr Labs decision for a blow by blow of what is coming You ain’t seen nothing’ yet as they are just warming up Don’t think it can’t happen to you ©2012 Flora Research Laboratories 10 You Don’t Want This I selected this warning letter for a reason which we will examine more closely ©2012 Flora Research Laboratories 11 Relevant Section “As an own-label distributor that contracts with other manufacturers to manufacture dietary supplements that your firm releases for distribution under your firm’s name, FDA considers you to be a manufacturer of such dietary supplements. You have ultimate responsibility for the dietary supplements that you introduce or deliver for introduction into interstate commerce.” ©2012 Flora Research Laboratories 12 Even More Relevant “The inspection revealed serious violations of the Current Good Manufacturing Practice (CGMP) regulation for Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements, Title 21, Code of Federal Regulations, Part 111 (21 CFR Part 111). These violations cause your dietary supplement products to be adulterated within the meaning of section 402(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. § 342(g)(1)], in that the dietary supplement products have been prepared, packed, or held under conditions that do not meet CGMP regulations for dietary supplements.” ©2012 Flora Research Laboratories 13 Look Again “These violations cause your dietary supplement products to be adulterated within the meaning of section 402(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. § 342(g)(1)], in that the dietary supplement products have been prepared, packed, or held under conditions that do not meet CGMP regulations for dietary supplements.” ©2012 Flora Research Laboratories 14 That Means Unlike ANY other food category of regulations, dietary supplements can be declared ADULTERATED because of cGMP violations We think of that word meaning some contamination such as fibers, hairs, wrong ingredient, rodent excreta and so on but It can be a violation of protocol What do you think consumers think ADULTERATED means? ©2012 Flora Research Laboratories 15 What FDA Said-Private Label CMO “As an own-label dietary supplement distributor that contracts with a manufacturer to manufacture a dietary supplement that you distribute under your own label, you have an obligation to know what and how manufacturing activities are performed so that your firm can make decisions related to whether your packaged and labeled dietary supplement products conform to established specifications and whether to approve and release the products for distribution [See 72 Fed. Reg. 34752, 34790 (Jun. 25, 2007)]. “ ©2012 Flora Research Laboratories 16 Your Firm’s QAU “Your firm's quality control personnel must ensure that your manufacturing, packaging, labeling, and holding operations ensure the quality of your dietary supplements and that your dietary supplements are packaged and labeled in accordance with established specifications, as required by 21 CFR 111.105 and 21 CFR 111.120(b).” Not ‘their firm’s QAU” but “your firm’s QAU” ©2012 Flora Research Laboratories 17 Important FDA Statement “Your firm failed to make and keep written procedures for the responsibility of quality control operations, as required by 21 CFR 111.103 and 21 CFR 111.140(b)(1). As an own-label dietary supplement distributor that contracts with a manufacturer to manufacture a dietary supplement that you distribute under your own label, you have an obligation to know what and how manufacturing activities are performed so that your firm can make decisions related to whether your packaged and labeled dietary supplement products conform to established specifications and whether to approve and release the products for distribution [See 72 Fed. Reg. 34752, 34790 (Jun. 25, 2007)]. Your firm's quality control personnel must ensure that your manufacturing, packaging, labeling, and holding operations ensure the quality of your dietary supplements and that your dietary supplements are packaged and labeled in accordance with established specifications, as required by 21 CFR 111.105 and 21 CFR 111.120(b).” ©2012 Flora Research Laboratories 18 And This “Your firm failed to establish a specification for any point, step, or stage in the manufacturing process where control is necessary to ensure the quality of the dietary supplement and that the dietary supplement is packaged and labeled as specified in the master manufacturing record, as required by 21 CFR 111.70(a).” ©2012 Flora Research Laboratories 19 Oh, And This Too “Your firm failed to establish specifications for each component that you use in the manufacture of your dietary supplement products, as required by 21 CFR 111.70(b).” ©2012 Flora Research Laboratories 20 Another one “Your firm failed to prepare and follow a written master manufacturing record for each unique formulation of dietary supplement that you manufacture, and for each batch size, to ensure uniformity in the finished batch from batch to batch, as required by 21 CFR 111.205(a).” ©2012 Flora Research Laboratories 21 Standard Closing Paragraph “You should respond in writing within fifteen (15) working days from your receipt of this letter. Your response should outline the specific things you are doing to correct the violations noted above. You should include in your response, documentation and any other useful information that would assist us in evaluating your corrections. If you cannot complete all corrections before you respond, you should explain the reason for your delay and state when you will correct any remaining violations.” ©2012 Flora Research Laboratories 22 And Finally (this is not from FDA) Sincerely, Your local FDA Office who will be watching you from now on very closely and will bring federal Marshalls in next time to seize your inventory, arrest your management and shut down your company if you fail to adequately respond to our warning letter. Oh, any by the way, we might just do that while you are responding to the letter because we can. ©2012 Flora Research Laboratories 23 This is not an idle threat The FDA has become very aggressive in enforcing the cGMP regulations and rightly so The fact that the industry had over a decade of warning about what would be expected means FDA is not very empathetic to those that just decided to start working on compliance now FDA and FTC work closely together and that means everything from trade show literature to import of raw materials used in your product are subject to review ©2012 Flora Research Laboratories 24 The 6 Stages of cGMP Acceptance 1. The cGMP’s will never get issued 2. The cGMP’s will never be enforced 3. Only the big guys will get hit now and then 4. Only the bad players with major deficits will be hit 5. Only those making the products (CMO’s or in-house manufacturing facilities will be hit 6. Oh my god, I’ve been hit! I need to comply. ©2012 Flora Research Laboratories 25 Steps to take with your CMO and factors to consider when you engage a CMO to make any product in 427,000 easy steps… (Just kidding, there are only 18,000 critical steps) ©2012 Flora Research Laboratories 26 Considerations A flashy website is nice and so are glossy brochures, pictures of lab equipment and people in lab coats So what? Really, so what? Does this actually reflect the real CMO’s focus or is their marketing department? As you scratch the surface, it can be like pulling the thread on a sweater that suddenly unravels Better to come apart in front of your audit team than the FDA CO! ©2012 Flora Research Laboratories 27 Gaps? Me? Not Prestigious Me? Nobody knows everything- we all have knowledge gaps You may not know what you don’t know until you have the counsel of qualified experts Rapidly assessing the gaps in your expertise and determining the best way to fill them is essential to success (hire in our outsource) Take advantage of those in the know to help make your product line rock solid & regulatory compliant by conducting a gap audit & evaluation ©2012 Flora Research Laboratories 28 Get Boots on the Ground! There are many very good CMO’s out there However, nobody is perfect & issues arise Don’t be the retailer that has never seen the CMO’s facility that makes your private label products Don’t go it alone unless you are an auditor and analytical chemist and microbiologist and regulatory affairs specialist and have x-ray vision and read minds (if you do, I have a job opening for you at the tables tonight in that poker competition) Hire some qualified help to fill in the gaps you have ©2012 Flora Research Laboratories 29 What am I saying? You do what you do best but if that is not qualifying a CMO, get someone that can or a team Saying “But I did not know that…” falls on deaf ears at FDA because by law it is your responsibility to know You did read the 900+ page preamble to the cGMP final rule right? If not you should as it spells out the FDA’s thinking on each point This is a common problem– CMO’s making products for private label and the client never audits them until its too late ©2012 Flora Research Laboratories 30 CMO Evaluation Auditing by a third party auditor with expertise in 21CFR part 111 Evaluation of the overall facility and logistics Knowing everything from how the ingredients arrive and are evaluated to how the final product is boxed and shipped out is your requirement so know it solid Make sure all aspects are compliant including documents There are common warning letter themes that we see repeatedly in situations like this ©2012 Flora Research Laboratories 31 CMO Partnerships Your liability exposure is significant so you need to have a CMO that operates transparently and cooperates with your team That means being an open book of sorts A spirit of cooperation towards a more compliant product, company and industry should be the philosophy If you get the runaround then run away to another CMO They work for you & need to comply too ©2012 Flora Research Laboratories 32 MMR/Product/Ingredient Specs YOU need to work with your CMO to establish a written master manufacturing record for each and every product you sell YOU need to work with your CMO to establish written specifications for each ingredient used and for each product made YOU need to work with your CMO to make certain that ALL of these specifications are properly implemented and AUDIT them to the specifications ©2012 Flora Research Laboratories 33 Common Issues- IDENTITY FDA’s biggest fear is based on historical disasters involving the mix-up of botanicals which resulted in consumer injury or death- hence IDENTITY YOU must establish and test incoming dietary ingredients to ensure proper identity and that the product is free from reasonably anticipated contaminants (RAC’s) You must use one or more scientifically valid examinations to meet this identity requirement ©2012 Flora Research Laboratories 34 Common Issues-IDENTITY We all know an onion from an apple but do we know if that yellow powder is goldenseal root extract standardized to 5% alkaloids? If you are a veteran in this industry, you can probably differentiate goldenseal from closely related adulterants based on taste, smell and appearance (organoleptic) but… ©2012 Flora Research Laboratories 35 Common Issues-IDENTITY If your product specification is GS extract standardized to 5% alkaloids you MUST ensure that the product meets this IDENTITY specification That will include making sure it is not adulterated with other botanicals or synthetic berberine (RAC’s) And that it contains the right amount of alkaloid content (assay) So you just have it tested in a lab right? ©2012 Flora Research Laboratories 36 Common Issues-LABORATORY Not all labs are created equal Do they know what they are doing and does the analyst have the training and qualifications to do what they are doing? Is the instrument calibrated and is the incoming standard characterized properly? Is the equipment being utilized correctly and do they have the proper equipment to do the test that they are supposed to be doing for you? Who is checking the checker? ©2012 Flora Research Laboratories 37 How Forensic TV Crime Shows Have Made Our Job Harder ©2012 Flora Research Laboratories 38 How We Wish Analysis Worked Unfortunately, this is not how it works except for the Tricorder on Star Trek & On CSI RESULT SAMPLE BLACK BOX SCIENCE ©2012 Flora Research Laboratories 39 How It Really Works Plus sweat! ©2012 Flora Research Laboratories 40 CRO’s & the Big Picture DS products and ingredients are highly complex (with some exceptions) and thus each test is really a study in itself A good CRO will step back and get the big picture of what is going on to assure that critical factors are not missed The Phytoforensic process starts with information gathering at all levels BEFORE analysis It requires outside-the-box thinking and high skill levels & a passion for excellence ©2012 Flora Research Laboratories 41 Laboratories Some labs are mills that put out data at a low price and high pace to make profit All profit is based on high throughput testing High throughput testing mandates limited scope, short time focus on any sample and low operator skill levels (people with jobs not careers) How much personalized attention is your sample going to get in this environment? How many problems slip by? More than you think… ©2012 Flora Research Laboratories 42 A Case Study- Phytoblab 9000 Phytoblab 9000 is a fictitious product that I am going to use for this exercise so that you can better understand the process – let’s say PB9K Situation, the CMO tests Phytoblab 9000 with the “machine that goes bing” (actually it is FTIR) and it does not go bing The material appears to be OOS The material is sent to an outside lab for evaluation ©2012 Flora Research Laboratories 43 The Laboratory & PB9K Laboratory sample receiving- the lab must have protocols in place for the receiving and handling of samples even if it is the laboratory inside the CMO’s facility- PB9K is received into the lab PB9K is tested by HPTLC using the laboratories compendia reference for the actual botanical in the formulation and it is legit- PASS? PB9K is tested by FTIR using a Phytoforensic examination and it is different than prior lots-FAIL? ©2012 Flora Research Laboratories 44 Phytoforensic Science Matters So you have a pass and a fail and that is initially inconclusive or confusing but very typical The lab reaches out to the supplier and they say that PB9K is made using an ancient Chinese process used for thousands of years but it is proprietary and they can only give us the ingredients/excipients used This is very common and it does not really fly in the face of new regulations- black box specs are not FDA OK! ©2012 Flora Research Laboratories 45 So What Else Is There? The scientists notice that the solubility parameters are not the same between the samples The insoluble part is mostly excipient That would easily explain the pass on HPTLC and fail on FTIR If the excipient ratios changed is it okay? NO- FDA considers that a deviation from the MMR and it requires a documentation process and OOS report! ©2012 Flora Research Laboratories 46 Phytoforensic Science Matters The PB9K sample that failed QC at the CMO’s facility is compared to older lots and we see differences in the minor compounds by HPTLC which is common for extracts Does it matter? Maybe. What does the spec say about the compounds in PB9K? That is the answer FTIR differences appear to be related to declared excipient changes so the material is OOS Conclusion- Failed Material or Deviation for OOS material use ©2012 Flora Research Laboratories 47 FDA Warning for an excipient? Would FDA really give a warning letter to a company because they had an excipient change? Yes they would and they did in a case where a company changed an excipient involving cellulose This caused the product to be misbranded and adulterated FDA takes this very seriously You should too if you want to thrive and you can thrive by doing the right things ©2012 Flora Research Laboratories 48 CRO A Partner for You A Contract Research Organization (contract laboratory) can be your partner in making sure that the CMO maintains compliance and in investigating issues like PB9K’s OOS incident Again, all labs are not created equal Look for a CRO that has expertise and the capability and ability to apply advanced techniques and multiple disciplines to the problem at hand (which may be highly variable over your products life cycle) Shopping on price alone will bite you eventually ©2012 Flora Research Laboratories 49 VISIT YOUR CRO! You should pay a visit to the facility and meet the team See the equipment and inspect work performed on your behalf Make sure that the employees are properly trained to do what they are doing Be certain that the CRO has the ability to apply many technologies and techniques to solve your problems Too often, labs pound square pegs into round holes and you don’t want that-DS products are complicated ©2012 Flora Research Laboratories 50 CRO’s Continued Don’t use a non-transparent CRO! They should be an open book for your partnership or their data is not usable for FDA compliance issues Proprietary means it can’t be evaluated so this old way of the lab world in the industries early days is no good The lab should be willing to assist you in an FDA inspection and agree to allow FDA to inspect their facility and data for your samples If they say no then go to another lab that you can use The CRO works for you! ©2012 Flora Research Laboratories 51 CRO Partnership Your CRO should be able to advise you on this from a long history of working in the industry and on products The CRO may not know a particular material but they certainly, as scientists, should be able to rapidly figure out what the issues might be and what should be evaluated This goes back again to choosing the right CRO partner ©2012 Flora Research Laboratories 52 Common Issues- State of Science In cases where the state of science does not allow for the testing of a given ingredient in a finished product the cGMP’s allow for exemptions For instance, if your final product contains 1 mg of PS, it is not possible to test that with current science (without a tremendous multi-million dollar multi-year research project) However… ©2012 Flora Research Laboratories 53 Common Issues-State of Science In the last five years, technology jumps have made possible what was impossible only a short time ago Your CMO and CRO must be on top of the science because FDA is and if you are making decisions on old data you are at risk We can now see compounds at about 100-1000 times lower levels than before due to technology jumps That means that the 25ug of selenium methionate in your finished product can be tested for the Se level and the raw material can be tested for identity ©2012 Flora Research Laboratories 54 Common Issues-State of Science FDA does not consider the cost of technology required to comply with the cGMP’s in evaluating this issue If you need a million dollar instrument to do the test then you either buy it or find a lab that has it and knows how to use it for your testing needs This is especially true for situations where the tests are for RAC’s that are a safety concern Put up or get out is the FDA stance on this matter and it shows in warning letters ©2012 Flora Research Laboratories 55 Common Issues RAC’s RAC’s are contaminants that are “reasonably anticipated” and you MUST assure that your ingredients and products are free from them While the law does allow you to use the suppliers C of A for all but identity, you must validate that information with your own testing Typical protocol is to test 6 lots and it all pass then do skip lot testing – for ingredients not finished product Some RAC’s should ALWAYS be tested for anyways ©2012 Flora Research Laboratories 56 Common Issues RAC’s How do you know what the RAC’s are for a given product? Utilize historical incidents to set precedence- i.e. melamine in protein, pesticides in ginseng, selenium super potency etc. Consider what would be used on or for a productpesticides for botanicals, dyes in bilberry, lead in calcium, carageenan in chondroitin What if you don’t know the RAC history or potential RAC’s to test for? ©2012 Flora Research Laboratories 57 RAC’s- API Spiking Clandestine API adulteration has become epidemic in the industry Some products are more at risk than others but NO PRODUCT is immune Testing a sample for known compounds is not enough Non-targeted screening is essential in high risk products Don’t risk it. This is the stuff that you can go to jail for Be sure your CRO is a leading expert in clandestine adulteration testing and that you are covered ©2012 Flora Research Laboratories 58 How Bad is Spiking? Samples sent for clandestine adulteration testing at FRL are adulterated more often than not It is not unusual for a 90% failure rate to occur in prelost shipments or offshore encapsulated/tableted products Raw material suppliers often add API’s to make the product appear high quality for repeat business The people doing this are very sophisticated and new compounds are continuously being discovered ©2012 Flora Research Laboratories 59 Systematic Phytoforensic Approach It is not uncommon for FRL to detect major pharmaceutical adulteration at active levels in products that were passed by labs in the US and Europe! Labs performing targeted screening miss novel analogues and pro-drugs SPA takes hours or days of expert time per sample in some cases-hence production labs miss many API’s This is a top concern of FDA ©2012 Flora Research Laboratories 60 Economic Adulteration Less than 1% of all products entering the US are inspected. Global trade is greater than ever before in the history of the US There are continuous cases of product contamination due to ingredient substitution Economic adulteration is at minimum a financial loss but is more often catastrophic Making sure the whole shipment is authentic is a challenge ©2012 Flora Research Laboratories 61 Representative Sample? Someus drumus Biggus contanerous Latin binomials from excessive roadrunner cartoons Micro sizeus test Dubious datus LOT REPRESENTATIVE TEST RESULT??? Stratificus bagus ©2012 Flora Research Laboratories 62 Common Issue- Sampling As we see from the prior slide, what you get in a shipment and what the laboratory tests may not always be consistent Tonnage of material can’t be evaluated with a ten gram sample The way the samples are taken, composited (if that is proper for the given test) and how the lab processes the sample before testing are all vital to getting lot representative data Why is this important? ©2012 Flora Research Laboratories 63 Common Issue- Sampling Because the cGMP’s and FDA say that the sample under examination by the laboratory must be lot representative Sampling is a science unto itself and we see most CMO’s do not take lot representative samples and are not in compliance thus the lab data is not in compliance thus the product made from the materials is MISBRANDED AND ADULTERATED! ©2012 Flora Research Laboratories 64 Representative of the Lot? Hypothetical Containers of Lot 123 Ice Cream Supplement for Mood Elevation ©2012 Flora Research Laboratories Scoop sample sent to lab for organoleptic testing- 65 Sampling Must be Validated! The cGMP’s require that sampling protocols be documented and validated to assure that they are lot representative All too often, samples sent to labs for testing are scoops off the top 6 inches of one container In a supertote or 20 drum shipment, that is not lot representative USP Articles of Botanical Origin requires multiple container sampling including core samples from different sections of the drums ©2012 Flora Research Laboratories 66 Typical Stratified Sample It takes more time for a laboratory to properly prepare the composite sample from this container than it does to conduct the analysis. What does your lab do? You need to know and it needs to validated! ©2012 Flora Research Laboratories 67 Laboratory Compositing The Scientifically Valid Sampling Plan for our Laboratory Sampling of Protein Powder for steroid testing takes about two hours to conduct. Dr. Mason (seen here) is a preeminent expert in statistical sampling plans. He has developed sampling plans used on some of the largest superfund sites. This method is an elaboration of the USP cut and quarter mix method but utilizes 8 stainless bowls to ensure uniform sampling of the large protein container. The final lab sample will be 100 grams. What is your lab doing? Bad sample = bad data. ©2012 Flora Research Laboratories 68 Take Away Points There is more to choosing a CMO than just getting a quote and checking their flashy website Even the nicest facilities I have been inside of had some raw materials that would never be considered compliant by FDA or methods that were not valid Many ingredients are very hard to characterize and because you must have specifications you must be certain to assure material identity How samples are taken for laboratory testing is the first critical control point in the ingredient evaluation process. Bad sample technique = cGMP violations ©2012 Flora Research Laboratories 69 Take Away Points CMO’s run the range from scumbags in rat infested warehouses to sincere and diligent first class facilities with great talent and skill The more you to do ensure your products are made to compliance with cGMP’s and to your product specifications, the less liability and exposure you have When you do not know how to do something, you should have trusted partners- a good CMO will work with you to help establish specifications and other necessary documents or bring in an expert to help ©2012 Flora Research Laboratories 70 Take Away Points Always have outside evaluation on a CMO by qualified experts (independent auditors) because it is your reputation and company that is at risk It is not about mistrust, it is about due diligence and making good business choices In the nearly 20 years I have been working with DS products, I have seen plenty of well intentioned CMO’s and retailers with private label products in serious trouble Work with trusted partners and trust nobody (within reason) ©2012 Flora Research Laboratories 71 Take Away Points Remember, FDA considers EVERYONE involved in the production, packaging, testing, holding and distribution of your product to be an extension of your company You are ultimately responsible for all of your partners actions so choose partners that will work with you CMO’s and CRO’s work for you and that means that they should support you in an FDA inspection Partners not willing to do this are not partners you want to work with ©2012 Flora Research Laboratories 72 The Good News The DS industry continues to grow even during the economic downturn More and more doctors and consumers are using DS products to maintain health Soon, most insurance companies will start covering supplements that are essential to preventing disease (such as a supplement program for metabolic syndrome) There is more technology and resources than ever before to help you succeed in the industry ©2012 Flora Research Laboratories 73 Finally While your CMO and CRO work for you, we all work for one common goal (or at least we should) That goal is to provide high quality dietary supplements made in compliance with the cGMP’s to the consumers that will buy and use them If we all do our job right and you make good products that help consumers, the recipe is win-win-win for all involved ©2012 Flora Research Laboratories 74 THANK YOU! Milo helps with research ©2012 Flora Research Laboratories 75