Gurugram hospitals grapple with shortage of remdesivirUpdated: Jul 09, 2020 00:00 IST
City hospitals are fast running out of the injectable antiviral drug remdesivir that is administered to moderately ill patients in emergency situations. The district administration said the supply of the drug is unable to keep up with the demand.
A 100mg vial of the drug costs ₹5,400 and is manufactured by USA-based Gilead Sciences and is distributed in India by Hetero Healthcare Limited. Recently, two other companies were given approvals to sell the patented drug to hospitals in the country by the Drug Controller General of India.
According to doctors treating Covid-19 patients, district drug control officials and the chemist association of the city, the availability of remdesivir in Gurugram is rather poor. “Currently, there are 250 vials available in the city in at least three-four big hospitals. The demand is high and supply is less,” said Amandeep Chauhan, district drug control officer, adding that only Hetero was currently supplying the drug to Gurugram.
Medanta Medicity, which is treating at least 134 Covid-19 patients, said their stock of around 100 vials at the beginning of the week has run out. Dr Yatin Mehta, chairman, critical care, Medanta Hospitals, said, “We don’t have any vials at present. There isn’t enough supply of the drug. The hospital sources it directly from the manufacturing company. If unavailable with us, patients will have to arrange it by themselves. We give them the prescription and the contact details of the person concerned with the manufacturing company in Maharashtra to provide the injection.”
At Medeor Hospital in Manesar, a designated Covid-19 hospital. doctors are reluctant to prescribe the drug. “The supply chain of remdesivir is not robust, which raises questions on the quality of the drug,” said Dr Manoj Sharma, senior consultant and incharge – internal medicine.
“The drug has been used in 3-4 patients earlier, where kin of the patients were asked to arrange for the drug on their own. A prescription was given to them with the hospital seal on it,” he said, adding that due to the hassle the family has to go through they hardly prescribe the drug.
Dr. Manoj Goel, director of pulmonology at Fortis Memorial Research Institute, on the other hand, said that the hospital currently had the drug. Sharad Mehrotra, president, Gurugram Chemist and Drug Association, said, “We are getting lot of enquiries for remdesivir. There are no distributors of the drug in the city and so people are arranging it from Delhi-based distributors.”
He said that the association has written to the manufacturing companies, and the state government to put into place a proper distribution policy.
Dr. Saket Kumar, managing director, Haryana Medical Services Corporation limited, said, “The department is ensuring the supply is not affected by coordinating with manufacturing companies.” A spokesperson for Hetero Healthcare Limited said, “Vials have been provided to hospitals that have placed their requirement with us. On June 20, the company received the approval from the government for manufacturing the drugs. 3-4 days later, 20,000 vials were given to different hospitals in the country. To address the shortage, we have asked private and state-run hospital to furnish the drug stock with them. From July 13, sufficient stock will be available.”
PREVENTING BLACK MARKETING
With the possibility of hoarding and black marketing of the drug, the district drug control department has been on high vigil. On July 6, the Central Drugs Standard Control Organisation (enforcement division) directed all state drug controllers to ensure remdesivir is not sold on the black smarket. “We have written to company to deploy their distributors in Gurugram. Hospitals are directly procuring the drug from manufacturers,” said district drug control officer Chauhan. “We have asked the hospitals to share the availability of remdesivir vials on a regular basis to ensure there is no scope for black market.”
‘Not a cure’
Senior doctors of private hospitals, who have been treating critical patients said that remdesivir is not a cure. “As per the Indian Council of Medical Research (ICMR) guideline it is an experimental medicine. It is only given to Covid-19 patients who are moderate to severely ill, especially those who are fresh admission to the Intensive Care Unit (ICU). It is not injected in patients who are in ICU for a long time,” said Mehta.
Since the drug impacts liver and kidney, doctors prescribe the drug only after proper investigation. “After that, if the patient requires remdesivir we ask the family to sign a consent form as it is an experimental drug,” said Dr. Manoj Goel of Fortis Memorial Research Institute, adding that the drug is given to patients who have oxygen saturation level below 94%. “Data suggests that the drug improves the recovery rate by 31% but does not improve the mortality rate. It is effective only in the initial phase of infection,” said Goel, who has used the drug in over 15-20 patients who were critical.
Ggm tally over 6,300
As per the district health bulletin on Wednesday, 133 new cases were reported, taking the total count of infected person to 6316. Of which 987 are active case, 5227 have recovered, while 102 have succumbed to the infection.