A shortage of the experimental antiviral drug Remdesivir has been observed across India, but more in Delhi. Many states are scrambling to source it from other cities and some are buying it at excessive prices.

Ever since 13th June, the Union health ministry had allowed its emergency use for treating COVID-19 patients with moderate symptoms, doctors are blaming the increased demand and shortage of the medicine.

Due to an increase in coronavirus cases across the country, more doctors are prescribing the drug, but the supply has not increased accordingly. Patients who are prescribed the drug are usually given six doses of the injection.

On 1st June, the Drug Controller General of India (DGCI) allowed Gilead Sciences, which holds the patent for Remdesivir, to import the medicine. The three Indian manufacturers, namely Hetero, Cipla, and Mylan have been allowed to manufacture this drug in India. A number of other companies, including Jubilant and Zydus are also awaiting approvals from the regulator. All these companies have signed agreements with patent holder Gilead.

The medicine was initially available in only a few hospitals throughout the country as a part of the World Health Organization’s solidarity trial for studying the effectiveness of several therapies for COVID-19.

At present, the generic (off patent) drug manufactured by Hetero is available in Delhi and has priced the product at Rs 5,400 a vial. Media has reported that it has manufactured and supplied 20,000 vials.

An official from Delhi’s drug control department who doesn’t want to be named said that the generics manufactured by other two companies might enter the market in the next few days and resolve the shortages. They have been asked to monitor the situation currently. There is also a Bangladeshi alternative of the drug that is available in India and is being sold to desperate patients.

Cipla has projected to launch its product before this weekend. Some state governments are lined to buy the drug and few of them had already placed orders with Hetero.

On Monday, DCGI wrote to drug controllers of the states to keep a check on black marketeering. The medicine is not available at pharmacies for personal use. It is sold for institutional use only to hospitals who are treating COVID-19 patients.

A Delhi resident, Abhay Shrivastav, said that he was searching for six vials of the Remdesivir injection prescribed to the 84-year-old mother of one of his family friends. Their patient was admitted to one of the biggest hospitals in the city. The doctor prescribed the medicine and informed them about a shortage in the hospital and asked the family to arrange for it. Shrivastav questioned if the drug was not supposed to be sold in the pharmacies then where can they get it from? Shrivastav was assured the medicine for Rs 65,000 a vial after he had posted a message on social media. His brother was able to find four vials of the medicine in Mumbai and was sending them via a courier.

Journalist Samarth Bansal said that he received quotations of Rs 30,000 per vial when he too started to search for the medicine for his grandmother. He said that the hospital prescribed the medicine to his grandmother on Sunday but it was unavailable in their pharmacy. They were asked to wait till Tuesday as an order was placed. His family tried to contact the company and bulk drug dealers. He then got in touch with a person at Bhagirath Palace, which is Delhi’s largest wholesale medicine market, who quoted the price. Now he is getting the medicine from Kolkata.

India’s drugs controller on Tuesday has instructed the state authorities to make sure that there is no black marketing or over pricing of Remdesivir as it has been allowed only under emergency use authorization for severely ill patients of COVID-19. A senior official in the drugs controller’s office said that the states are directed to take strict action against the defaulters.

Delhi’s both private and government hospitals have reported reducing stock of the medicine. Fortis Healthcare in a statement said that there is a shortage of Remdesivir as the drug has now been approved as a first-line treatment for moderate to severe COVID-19 patients. Also, the demand has been increased. Currently, they manage through the inter-unit transfer of available stocks within the hospitals that are based on requirements. They have received support and reassurance of fresh supplies from the manufacturer. They even understand that other manufacturers are too entering the market soon, and hopefully, this will ease out the shortage to some extent.

Max Hospital, Saket, which is one of the first private hospitals in Delhi to start the treatment of COVID-19 patients, had also reported a shortage of the Remdesivir drug since the last three days.

Source: Hindustan Times