Remdesivir over-prescribed, supply short: Gujarat to High Court

AHEAD OF the Gujarat High Court’s hearing of a suo motu PIL on the Covid-19 situation on Thursday, state Principal Secretary (Health) Jayanti Ravi filed an affidavit in the court on Wednesday, reiterating that according to the World Health Organization there was no evidence that remdesivir “improves survival in corona patients” and that the Department of Pharmaceuticals had red-flagged the over-prescription of the antiviral drug last year.

The Gujarat government also submitted that it has written to the chairman of National Pharmaceutical Pricing Authority to examine the issue of wide-ranging prices of remdesivir and to take “necessary immediate action”.

“Remdesivir is recommended to be given to the patients complaining of high grade fever continuously for a longer period with lack of oxygen saturation, under emergency use authentication and medical supervision… It is reported to reduce hospitalisation period,” the government affidavit said.

The government said it would supply around 25,000 injections daily to hospitals and patients in need.

Remdesivir is being over-prescribed, and doctors and hospitals are prescribing the injections even for those suffering from mild problems of breathlessness, the affidavit said, citing newspapers reports, including The Indian Express (April 12).

The government admitted that with a rise in Covid cases, “a short supply of the said injection has, in fact, taken place, causing an anxiety about the continuous and adequate supply thereof”. Only sufficient availability of the injection could take care of the anxiety, it said.

The government told the court that with the fall in demand following the drop in Covid-19 cases, the seven manufacturers had scaled down production “to about 5-10%, which affected the supply chain of the said product”. The manufacturers had said they needed at least 25 raw materials in production which might take time followed by a cycle period of 20 to 25 days “from production to transportation of the product”, it said.

It said “owing to a wide diversity in the MRPs” of the drug – because of the fact that it is not covered by the Drug Price Control Order, 1995 – there have been cases of hoarding, black marketing, and short supply of the injection, the government said. Six cases of illegal sale of remdesivir had been registered in Vadodara, Rajkot and Ahmedabad, it said.

The government said in the affidavit that given the limited supply, it has had to adopt a method of rationing the drug. Priority will be given to patients admitted in government and corporation hospitals, followed by those at the Covid-19 designated private hospitals and Covid care centres.