1st Edition

The Combination Products Handbook A Practical Guide for Combination Products and Other Combined Use Systems

Edited By Susan Neadle Copyright 2023
    614 Pages 119 B/W Illustrations
    by CRC Press

    Combination products are therapeutic and diagnostic products that combine drugs, devices, and/or biological products. According to the US Food and Drug Administration (FDA), “a combination product is one composed of any combination of a drug and a device; a biological product and a device; a drug and a biological product; or a drug, device and a biological product.” Examples include prefilled syringes, pen injectors, autoinjectors, inhalers, transdermal delivery systems, drug-eluting stents, and kits containing drug administration devices co-packaged with drugs and/or biological products. This handbook provides the most up-to-date information on the development of combination products, from the technology involved to successful delivery to market. The authors present important and up-to-the-minute pre- and post-market reviews of international combination product regulations, guidance, considerations, and best practices.

    This handbook:

    • Brings clarity of understanding for global combination products guidance and regulations
    • Reviews the current state-of-the-art considerations and best practices spanning the combination product lifecycle, pre-market through post-market
    • Reviews medical product classification and assignment issues faced by global regulatory authorities and industry

    The editor is a recognized international Combination Products and Medical Device expert with over 35 years of industry experience and has an outstanding team of contributors. Endorsed by AAMI – Association for the Advancement of Medical Instrumentation.


    Part 1: Foundation

    Chapter 1 Introduction

    John Barlow Weiner

    Chapter 2 What is a Combination Product?

    Susan Neadle

    Chapter 3 Regulatory Strategies

    Suzette Roan

    Chapter 4 cGMPs

    Susan Neadle and Mike Wallenstein

    Chapter 5 Integrated Development

    Susan Neadle

    Chapter 6 Risk Management

    Susan Neadle, Richard Wedge, and Edwin Bills

    Chapter 7 Human Factors Engineering in the Design, Development and Lifecycle of Combination Products

    Shannon Hoste, Stephanie Canfield, Susan Neadle, Bjorg Hunter, Theresa Scheuble

    Chapter 8 Lifecycle Management: Design Transfer through Post Market

    Susan Neadle and Khaudeja Bano

    Chapter 9

    9A. Best Practices and Considerations for Combination Products Inspection Readiness

    Susan Neadle

    9B. US Combination Product Inspections

    Kim Trautman

    Part 2: Special Topics

    Chapter 10 Supplier Quality Considerations

    Fran DeGrazio and Meera Raghuram

    Chapter 11 Analytical Testing Considerations

    Daniel Bantz and Jennifer Riter

    Chapter 12 Biological Products Considerations

    Manfred Maeder

    Chapter 13 Connected Health

    Ryan McGowan

    Chapter 14 Evolving Global Regulatory Landscape

    Stephanie Goebel, Viky Verna, Chery Marty and Susan Neadle


    • Comparative Overview of Global Combination Product Regulatory Landscape

    Dhiraj Behl and Susan Neadle

    • Glossary


    Susan Neadle, MS, BS, FAAO is a recognized international Combination Products and Medical Device expert with over 35 years of industry experience. Networked, published, highly active in numerous industry groups and with links to a number of teaching institutions, Susan brings deep knowledge and genuine passion for sharing that knowledge with others. Susan’s leadership, innovation, and best practices have been recognized with multiple awards, including the Johnson Medal, Johnson & Johnson’s highest honor for excellence in Research & Development, and most recently, as a Finalist in TOPRA’s 2021 Awards for Regulatory Affairs Excellence. She serves as Principal Consultant and President of Combination Products Consulting Services LLC, applying her extensive leadership, technical skills, and complex program management experience to provide international quality & compliance, regulatory, design excellence and executive advisory consulting services to the pharmaceutical, biotech and medical device industries. Among her significant industry affiliations and contributions, she serves as Chair of the ISPE Combination Products CoP, lead author on the ASTM International Combination Products Standard Committee, lead author on the AAMI Combination Products Steering Committee, active member in Combination Products Coalition, and serves as faculty at AAMI and at University of Maryland Baltimore County Campus College of Natural and Mathematical Sciences for Combination Products Curricula.

    Susan retired from Johnson & Johnson, where her distinguished 26+ year-career included integral leadership roles in R&D, Quality Engineering, Design-to-Value, and Quality Systems Management, spanning pharmaceuticals/biotech, medical devices, and consumer health sectors, as well as strategic leadership at J&J corporate level. She served as Chair of J&J’s Design Council, advancing world-class practices in product and process design and development to drive robust, customer-centric health care solutions across J&J. She also led J&J's cross-sector Combination Products Community of Practice. Among several achievements, Susan led the team that defined and implemented the globally integrated business model to meet Combination Products health authority regulations for Janssen, J&J’s Pharmaceutical sector, and was awarded the Johnson Medal for excellence in Research and Development.

    Susan also served as Executive Director and Head of Combination Products, Medical Devices, Digital Health & IVD Regulatory Affairs at Amgen, providing strategic leadership in global combination products/ device regulatory development and portfolio/project management from initial clinical investigation through registration and commercial lifecycle. She was as an advisor for internal regulatory policy priorities, health authority engagement and submissions approaches through strategic engagement and mentoring of colleagues for individual projects and portfolio. She led interactions with multiple global health authorities, and served as a catalyst for external consortium deliverables and strategic direction.