Remdesivir shortage in Maharashtra public hospitals

State governments typically coordinate drug orders for public hospitals, where most Covid-19 patients are treated. In some states, including Gujarat and Delhi, the city with the most cases, public hospitals have their own procurement systems.

AFP
Mumbai: Public hospitals in Maharashtra, the state with the highest number of active Covid-19 cases, are facing a shortage of Remdesivir because the local authorities are yet to place orders for the experimental drug that was approved for sale in India 10 days ago.

The bulk of the doses sold so far has gone to Tamil Nadu, which placed advance orders for the drug, and to private hospitals. Assam and Karnataka, which together have less than 15% of Maharashtra’s active caseload, are the other states that have placed orders for Remdesivir.

State governments typically coordinate drug orders for public hospitals, where most Covid-19 patients are treated. In some states including Gujarat and Delhi, the city with the most cases, public hospitals have their own procurement systems. The All India Institute of Medical Sciences in the capital said it had floated a tender after the drug was approved for sale and it has enough stocks of Remdesivir.


Maharashtra, with almost 76,000 active cases – half of them from Mumbai and Thane alone – was among the states that pushed the drug controller to expedite approval for the sale of Remdesivir. However, it hasn’t started processing the tender for the drug, according to state government officials who did not want to be identified.

Brihanmumbai Municipal Corporation, Mumbai’s civic governing body, is yet to order an initial consignment of 15,000 doses of the drug. An estimated 5,877 patients in the city are on oxygen support and would be candidates for treatment with Remdesivir.

The state had planned to import the drug from Bangladesh a few months ago, before the regulator’s approval for the drug.
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Hyderabad-based Hetero Labs and Mumbai-based Cipla received emergency marketing approval from the Drug Controller of India on June 21 to supply Remdesivir injection vials in India for moderate Covid-19 cases – patients on oxygen support. The course of treatment – five vials – costs Rs 28,000 to Rs 36,000.

The approval came almost a month after the companies signed voluntary licence agreements with US drug maker Gilead Sciences, which holds the patent for the drug.

While the companies had said they would start supplying the drug immediately, only Hetero has started selling it. Cipla’s official supply will start on July 9, ET has learnt. Cipla did not respond to ET’s queries on the shortage of the drug and when it will start supplies.

Hetero said it has so far supplied 20,000 doses of the drug, of which half went to Tamil Nadu which had made advance purchases, 7,000 went to private hospitals and the rest to other state-run hospitals in the country.
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“We are geared up to produce half a million doses by August for this drug and are geared up for the supply making every effort to ensure that state governments get them,” said Vamsi Krishna, MD of Hetero.

Krishna said the company has the active pharmaceutical ingredient to make 1 million doses of the drug and production won’t be disrupted by issues such as the border tension with China, the key supplier of such bulk drugs.
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Five more companies are expected to launch their versions of Remdesivir in India in the next few months. Gilead said in May that it will start selling its drug in India in July. In an email to ET the company said it is pleased to have learnt that its licensee partners will be launchimg the drug soon.

In the developing world, we have entered into non-exclusive voluntary licensing agreements with 9 generic manufacturers to further expand access and supply of remdesivir, a Gilead spokesperson told ET, adding that these agreements will help serve 127 countries classified as lower-income or that face significant obstacles to healthcare access. "Gilead continues to discuss with UNICEF the possibility of donating remdesivir for use in the low- and middle-income countries. We hope to finalize these arrangements soon", the company said.
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