There is a shortage of the experimental antiviral drug Remdesivir across India, but especially in Delhi, with many scrambling to source it from other cities or buying it at exorbitant prices.
Doctors blame increased demand and limited supply of the medicine for its shortage since the Union health ministry on June 13 allowed its emergency use for treating Covid-19 patients with moderate symptoms. An increase in cases around the country has seen more doctors prescribing the drug , but supply hasn’t increased proportionately. Patients prescribed the drug are typically given six doses (each is an injection).
The Drug Controller General of India (DGCI) on June 1 allowed Gilead Sciences, which holds the patent for Remdesivir, to start importing the medicine. Three Indian manufacturers – Hetero, Cipla, and Mylan– have since been allowed to manufacture the drug in India. Several other companies, including Jubilant and Zydus are awaiting approvals from the regulator. All of them have signed agreements with patent holder Gilead.
The medicine was earlier available at only a few hospitals across the country as part of the World Health Organisation’s solidarity trial to study the efficacy of various therapies for Covid-19.
Currently, the generic (off patent) drug manufactured by Hetero is available in Delhi. The company has priced the product at Rs 5,400 a vial. Media reports say it has thus far manufactured and supplied 20,000 vials.
“The generics manufactured by two other companies are likely to enter the market over the next couple of days and resolve the shortages. For now, we have been asked to monitor the situation. There is a Bangladeshi variant of the drug available in India that is being sold to desperate patients,” said an official from Delhi’s drug control departmentwho asked not to be named.
Cipla is expected to launch its product before the end of the week. Several state governments are also in line to buy the drug; some have already placed orders with Hetero.
DCGI wrote to drug controllers of the states on Monday asking them to keep a check on black marketeering.
The medicine is unavailable at pharmacies for personal use and is sold for institutional use to hospitals treating Covid-19 patients directly.
Abhay Shrivastav, a Delhi resident, said he has been looking for six vials of the Remdesivir injection prescribed to the 84-year-old mother of a family friend. “Our patient is admitted to one of the biggest hospitals in the city. The doctor there prescribed the medicine and said that there was a shortage in the hospital and the family would have to arrange for it. If the drug is not supposed to be sold in the pharmacies, where can we get it from?” Shrivastav has been assured the medicine for Rs 65,000 a vial after he posted a message on social media . His brother has been able to find four vials of the medicine in Mumbai and is sending them via a courier.
Journalist Samarth Bansal said he received quotations of Rs 30,000 per vial when he started looking for the medicine for his grandmother. “The hospital prescribed the medicine to her on Sunday but did not have it available in their pharmacy. They asked us to wait till Tuesday as an order had been placed. We tried to get in touch with the company and bulk drug dealers. Someone I knew got me in touch with a person at Bhagirath Palace [Delhi’s largest wholesale medicine market] who quoted the price,” he said. He is getting the medicine from Kolkata.
After receiving several complaints of drug shortage, India’s drugs controller on Tuesday directed state authorities to ensure there is no black marketing or over pricing of Remdesivir that it has allowed under emergency use authorisation for severely ill patients of Covid-19. “The states have been directed to take strict action against the defaulters” said a senior official in the drugs controllers office.
Both private and government hospitals in Delhi have reported depleting stock of the medicine. “There is a shortage of Remdesivir to some extent since the drug is now approved as a first-line treatment for moderate to severe [patients]… and demand has increased. We are currently managing through the inter-unit transfer of available stocks within the hospitals based on requirements. We have received support and assurance of fresh supplies from the manufacturer. We understand that other manufacturers are also entering the market shortly, and hopefully, that will ease out the supply shortage to some extent,” said Fortis Healthcare in a statement.
Max Hospital, Saket, one of the first private hospitals in Delhi to start treating Covid-19 patients, also reported a shortage of the drug over the last three days.
“We have not received any fresh stocks of this important drug since the beginning of this month. This could be because of having only one manufacturer across the country as of now. We are hopeful that the scenario may change by the end of this week with some more drug manufacturers joining in,” the hospital said in a statement.