As states face Remdesivir crunch, people turn to black market to save kin
Even as the country is in the throes of a second wave of the coronavirus pandemic, several states are grappling with an acute shortage of Remdesivir, the vital high-value drug used in the treatment of severe COVID-19 infection.
Faced with the crisis, both private and government hospitals in Karnataka, are asking attendants of patients to procure the medicine from outside. Having no information on the availability of the drug, several people made frantic calls and visits to multiple medical stores to procure it. The desperation to save their loved ones has forced many to shell out up to ₹9,600 per vial, roughly about 200-300% of the actual price of the medicine.
In Tamil Nadu, some of the private hospitals redirected incoming patients to government hospitals as the injections were short in supply and doctors feared they would not be able to treat COVID-19 patients without it.
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Ravi (surname withheld to protect identity), who was looking for the injection for the treatment of his COVID-infected brother at a speciality hospital in Bangalore’s Kammanahalli area said, after nearly 10 pharmacies turned him away, saying the medicine was out of stock, he procured four injections – two at the cost of ₹9,600 and two more at the cost of ₹8,000 from chemists who sold it in the black market.
Even as his brother is in a serious condition, Ravi rued about the system which has left patients and their attendants hassled.
In Bengaluru’s Janapriya Hospital, the medical staff said they had no choice, but to ask the attendants of patients to purchase the drug from outside as the government was not supplying enough.
Ravi Kanzal, a resident of Bengaluru, who had helped people in medical emergencies and in procuring the drug, said there was no such shortage of the medicine two weeks ago. But he says, as COVID-19 cases started to pile up, people from other states ordered the drug from Karnataka and some even hoarded it in fear of future unavailability, which in turn created a shortage in Remdesivir stock.
Currently, at least seven companies are marketing Remdesivir under a voluntary licensing agreement with M/s. Gilead Sciences, USA. These include Zydus Cadila (Remdac priced at ₹2,800 per 100mg vial, but now reduced to ₹899), Cipla (Cipremi at ₹4,000), Jubilant Lifesciences (Jubi-R at ₹4,700), Mylan (Mylan Esrem at ₹4,800), Hetero Labs (Covifor at ₹5,400), Dr. Reddy’s (Redyx priced at ₹5,400) and Syngene Internations (price could not be ascertained).
Dr Om Prakash Patil, director of health and family welfare admitted a shortage of the drug in the state and said that they have advised hospitals to procure it from the drug controller.
“There is a shortage and the stock could last for three days. And the state is expected to procure more in the next two days, which will last till the weekend,” Patil said.
The Gujarat high court on Monday pulled up the state government for the shortage of the drug and ordered it to make the medication available for all, like paracetamol. The court observed this while hearing the suo motu public interest litigation. “The state can always find those hoarding and selling at higher prices and take stringent action,” the court said.
Now, the Union government in a bid to ensure easy access to the drug, has ordered all domestic manufacturers to display details of their stockists/distributors on their website.
Stating that the country failed to foresee a second wave of the pandemic, Dr GR Ravindranath, general secretary of Doctors Association for Social Equality blamed the Centre of exporting Remdesivir when infections seemed under control a few months ago.
“They (government) shouldn’t have exported the medicine. The shortage could have been controlled otherwise,” Ravindranath said. “At a time like this, the government should come forward to cancel the patent rights and it can manufacture on its own. Or it can issue emergency licenses to some more pharmaceutical companies to manufacture,” he added.
Ravindranath said that the country was producing only 1.5 lakh units of the drug per day and there’s an imminent need to increase the production with rising COVID cases.
Even Puducherry has reported a shortage of the drug. To address the crisis, Telangana Governor Tamilisai Soundararajan, who has been given the additional charge of Puducherry, brought 1,000 doses of the drug on her way back to the Union territory after attending Ugadi celebrations in the Telugu state.
Ravindranath said such measures would set a wrong precedent as taking Remdesivir from one state and distributing it in another was not right and instead the Governor should push the Centre to supply more injections.
K Manoharan, president, Tamil Nadu Chemists, and Druggists Association said Tamil Nadu hasn’t faced a situation like in Karnataka, where people directly approached medical shops asking for the injection. “We hope by next week most of the hospitals will stock up the medicine sufficiently,” he added.
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Meanwhile, Zydus Cadila’s spokesperson told PTI that the current spike in COVID-19 cases has led to a higher demand for Remdesivir and they are producing more at their facilities. “To cater to the demand we have ramped up our production from the earlier 5-6 lakh vials a month to 10-12 lakh vials a month, which we will scale towards 20 lakh vials a month.”
In a few weeks the supply situation will be a far more stable one, the company said in a statement.
Similarly, Cipla said it is making every effort to ensure that its version of Remdesivir reaches more people in the country.
“We have scaled up the production of Remdesivir by 2x from the last wave of the pandemic. Given the unprecedented demand for the drug, we have now further ramped up our capacities through our network, to service the demand,” Cipla has said.
