Bihar withdraws free supply of black fungus drugs to pvt hospitals

Faced with a shortage of drugs of mucormycosis or black fungus, the Bihar government has stopped free supply to private health facilities

Faced with a shortage of drugs of mucormycosis or black fungus, the Bihar government has stopped free supply to private health facilities.

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This has come as an additional burden for patients, as the Liposomal Amphotericin B injection, a specific drug for the cure of mucormycosis, is costly besides being scarce and available through government channel.

“We are procuring the drug for anything between ₹4,000 and ₹7,000 per vial, depending on the brand available, and billing it to our patients,” said Dr Asif Rahman, medical superintendent of the Paras-HMRI hospital, accredited to the National Accredited Board of Hospital (NABH).

Depending on the severity of the fungal infection, a patient requires an average of six vials of injection of Amphotericin B a day. The government was earlier supplying them free of cost to private healthcare facilities, providing some financial relief to patients undergoing treatment in the private sector. The state government had declared mucormycosis a notifiable disease on May 22.

Ruban Memorial hospital, another NABH accredited hospital, has also begun charging patients for drugs of mucormycosis.

“We charge our patients for the drugs at the same price we buy them through government channel after the government stopped its free supply,” said Dr Satyajit Kumar Singh, managing director of Ruban hospital.

Patients undergoing treatment at government health facilities, however, continue to get the drug free of cost. The free supply of the drug to private players was stopped around 10 days back.

The Indira Gandhi Institute of Medical Sciences (IGIMS) and the All India Institute of Medical Sciences (AIIMS), which bear the brunt of patient load, are struggling to get a requisite quantity of the drug.

“We are dependent solely on government supply for drugs to cure black fungus. Against our daily requirement of over 600 vials, we get a small quantity of Amphotericin B, not even enough to last a day, at an interval of 3-4 days sometimes, causing hardship to patients,” said a doctor in the know of drug inventory at the IGIMS.

The AIIMS, on the other hand, is trying to procure them directly through manufacturers or local vendors by entering into rate contract with them, said Dr Kranti Bhavana, additional professor and head, department of ENT (ear, nose & throat) at the AIIMS.

“We are facing an acute shortage of drugs against our average daily consumption of 500-600 vials every day,” she said. The AIIMS had over 101 patients of black fungus under treatment as on June 11, but the government supply of the drug was erratic and inadequate.

The same day, the IGIMS had 116 patients out of the total 174 cases reported at the institute since May 18, when it came up with a separate ward for patients with mucormycosis, said its medical superintendent Dr Manish Mandal.

The IGIMS achieved a small milestone when it operated upon its 100th patient with black fungus last Friday.

“Our team of ENT, eye and neurosurgery experts performed a rare surgery on Saturday when they extricated fungus of the size of a cricket ball behind the eye orbital of a 60-year old man from Jamui district, without causing any vision loss to the patient,” said Dr Mandal. The institute had completed 106 surgeries of mucormycosis till Saturday.

“We operate 8-10 patients of black fungus on an average daily,” said Dr Rakesh Kumar Singh, professor and head, ENT, IGIMS.

“We use Amphotericin B and Posaconazole drugs on our patients. Depending on the severity of the infection, it takes 4-6 weeks generally for patients to become stable,” added Dr Singh.

Bihar had so far reported 562 cases of black fungus and 76 deaths, of which three died on Sunday. As many as 333 patients were under treatment, as per the health department’s bulletin on mucormycosis, the first released on Sunday, after it declared the fungal infection a notifiable disease on May 22.

Efforts to reach Manoj Kumar, executive director, State Health Society, Bihar, proved futile.