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WHY THERE’S SHORTAGE OF REMDESIVIR AND WHAT IS BEING DONE ABOUT IT?

At a time when the fresh COVID-19 cases are increasing, the states of Maharashtra, Madhya-Pradesh, Delhi, Chhattisgarh, and Gujarat are reporting the shortage of ‘remdesivir’ which is an antiviral drug. The Directorate of Foreign Trade, Ministry of Commerce & Industry, on Sunday (11th April), prohibited the export of remdesivir and active pharma ingredients (APIs) which are required in the production of the drug until further order/notice.

By injecting remdesivir, its anti-viral properties help in preventing replication of the virus. Initially, remdesivir was manufactured in 2014, for treating Ebola, and later it was being used for treating MERS & SARS. And from 2020, it is being used for treating COVID-19 (Coronavirus). This drug acts effectively in COVID patients who are at an early stage of hospitalization or are mildly ill, but its effectiveness drops by many folds at a later stage of infection.

The Remdesivir Crisis

India now has more than 12 lakh active COVID-19 cases. Maharashtra – where a majority of the COVID cases are concentrated, now needs around 50,000 vials of remdesivir daily.

Last year, when the COVID cases were at a peak in Maharashtra, it needed around 30,000 vials each day, yet this year, the requirement has increased. Manufacturing and supplying issues of remdesivir vials is making the situation worse.

On the other hand, Madhya-Pradesh has been complaining that it is receiving only half of its requirements. Almost 70% of the vial production is supplied to Maharashtra, and the remaining 30% is distributed in other states.

Demand & Supply

During September 2020, the number of COVID cases was at a peak in India, but later from September 2020 to February 2021, the number of cases dropped largely. During this time, the drug manufacturers had piled up the stocks of remdesivir, and its demand had dropped. So, for almost 3-4 months, the production of remdesivir vials was almost negligible.

But, since March 2021, the second wave got triggered, and the number of COVID cases started spiking up once again. So, there was a sudden increase in the demand for remdesivir once again, and as a result of this, its stocks started getting exhausted.

Soon, the remdesivir manufacturers like Hetro-Healthcare, and Kamla Lifesciences (Cipla) began to produce the drug once again. But the problem is that producing remdesivir requires at least 25 different raw materials, and the supplier couldn’t supply them quickly (on short notice).

The whole cycle of producing remdesivir right from the raw materials, to the final product, and its transportation takes almost 20-25 days. So, for piling up and supplying new stocks, a considerable amount of time is needed.

What’s next?

All seven remdesivir manufacturers in India have been asked to scale up the production to their maximum capacity of 38.80 lakh vials each month, by the Department of Pharmaceuticals. This includes:

– Hetro Healthcare – 10.50 lakh vials

– Cipla – 6.20 lakh vials

– Zydus Cadila – 5 lakh vials

– Mylan – 4 lakh vials

– Others – 13.1 lakh vials

The remdesivir vials are quite expensive, and their price ranges from ₹ 899 – ₹ 5,400 per 100 mg vial. The prices for 100 mg vials of different brands are as follows:

– Zydus – ₹ 899

– Cipla – ₹ 4,000

– Jubilant – ₹ 4,700

– Mylan – ₹ 4,800

– Hetro – ₹ 5,400

– Dr. Reddy’s Lab – ₹ 5,400

The inflation in its prices is due to over-prescription of the vials, to the patients who don’t need them or who won’t benefit from it.

Overall, the stocks of remdesivir will soon get piled up in all states (who need them) and the supply cycle will run smoothly once again. But, the prices of vials still remain high.

Source: The Indian Express

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