Hoarding of anti-viral drug Remdesivir, first reported in Mumbai, has quickly spread to several cities in western, central, northern and eastern parts of the country, forcing the Union Government and state governments to swing into action.
Used widely all over the country for treating COVID-19 patients right now, the key drug first started disappearing from the shelves of Mumbai’s pharmacies which triggered hoarding and black-marketing in a number of states including Gujarat, Madhya Pradesh, Delhi, Kolkata and Jharkhand. In Maharashtra, scarcity has been reported in Nagpur, Pune and Nashik, apart from Mumbai which happens to be the most affected city in the country due to rampant spread of COVID-19 in the past few weeks.
Why did production decline?
As the cases started declining by the end of last year, producers of Remdesivir reduced production in line with ebbing demand in the market. Some companies like Zydus Cadila even reduced the price of the drug in view of the slowing demand. Since COVID-19 cases rose rapidly in the past few weeks, the producers of the anti-viral drug have clearly failed to keep up with the demand. This is the reason for scarcity right now, said industry sources.
To meet the surge in demand for Remdesivir, the Centre is in touch with key manufacturers of the anti-viral drug including Sun Pharma, Mylan, Jubilant Life Sciences, Cipla, Zydus Cadila and Hetero Labs. It is estimated that the combined capacity of these companies is to produce around 30 lakh vials per month and they can produce a few lakh vials more by stretching their operations for a few weeks.
Several state governments, including Gujarat, and some municipal bodies like those of Mumbai as well as Pune, are placing bulk orders with the manufacturers, while others procure the anti-viral drug through wholesale dealers. Gujarat alone has placed orders for three lakh doses, sources said.
As the number of coronavirus-infected patients is increasing every day, anti-parasite drug Ivermectin as well as antibiotics like azithromycin and doxycycline are also in demand. Though opinion differs in the medical world over use of these drugs, right now they are widely in use. While a section of doctors is of the opinion that there is no need to use Remdesivir to treat patients infected by coronavirus, another section believes that the broad spectrum anti-viral drug is useful, especially in the case of hypoxic patients who suffer due to low oxygen levels in their blood. There are also differing opinions about the effects of Remdesivir on COVID-19 patients with severe to mild symptoms observed so far.
Since there is no established line of treatment for definite recovery of those suffering due to infection by the Wuhan virus, Remdesivir continues to be in demand as of now despite questions raised over its effectiveness. Before COVID, Remdesivir was used to treat SARS and the demand is now going through the roof just like the demand was for hydroxychloroquine last year, said a doctor on the condition of anonymity. Usage has only increased despite questions about the efficacy of the broad spectrum anti-viral drug, he added.
Hoarding and black marketing in Mumbai
Remdesivir is a prescription drug that is not to be sold over the counter, but such is the demand now that hoarding has created shortage of the medicine in Mumbai hospitals, forcing relatives and friends of patients to run from pillar to post for obtaining a few doses of the anti-viral drug. With the local authorities cracking the whip after a flood of complaints, now arrests have started taking place and around 300 vials of Remdesivir hoarded for black-marketing were seized in Mumbai. Some hospitals and pharmacies are fleecing patients by charging upto Rs 5,000 for a dose of the anti-viral drug while some manufacturers have cut their price below Rs 1,000 a dose on the basis of requests from state governments. Unscrupulous elements are resorting to illegal means by cashing in on high demand and the situation is similar to what happened to patients who were hospitalised last year.
The scarcity in Mumbai is despite the financial capital getting around 50,000 vials of the medicine daily on an average and the local municipal corporation now stepping up procurement to around 1.5 lakh vials per day to ease pressure on demand. Similarly, the Pune Municipal Corporation is taking steps to step up availability. While hospitals in states like Delhi, Punjab, Gujarat and Uttar Pradesh are not overflowing like the facilities in Maharashtra that so far remains the worst affected by Covid-19, hoarding has started by those looking for astronomical profits by black marketing.
No shortage in southern states
Interestingly, there is no major shortage of Remdesivir in south Indian states though coronavirus infection has been spreading rapidly in Kerala, Tamil Nadu and Karnataka. However, considering the increasing numbers, the Union Government is keeping a close eye on all states where the rate of infection has been high.