Remdesivir to remain scarce till April 20, officials point at production cycle, overprescription

The shortage of Remdesivir in Pune is going to last till at least April 20, Dinesh Khivasara, Assistant Commissioner of Food and Drugs Administration (FDA) in Pune said. Pune and several other COVID hotspots in Maharashtra are facing an acute shortage of the antiviral drug administered via injections, which is widely being used to treat the hospitalised COVID patients. While patients have been questioning why such an important medicine is not in stock, the FDA Assistant Commissioner pointed towards the hospitals using the injection more than necessary this time, as compared to last year.

“The whole process of production of Remdesivir takes around 20 days. The cases in the state began rising at this rate around April 1. So that was when the companies were asked to increase production. It will take another 20 days for the medicine to be available in stock,” Khivasara said.

Meanwhile, the Pune Municipal Commissioner Vikram Kumar, on Thursday, said in a press conference that the Pune Municipal Corporation was in contact with the FDA for more supplies of Remdesivir and that the city was to get around 2,000 vials on Thursday as well as Friday.

The daily numbers of COVID-19 patients in Pune and Maharashtra increased from a few hundred to a few thousand over a period of a few weeks from February to March 2021. While more people were getting treated at home when the second wave began, the number of patients in different governments, as well as private hospitals, has also increased. 

“We have observed that Remdesivir is being overprescribed. Earlier, the injection was administered not immediately after a person was admitted, but only if his condition was serious. Remdesivir would be given to patients with a CT score above 12-15 or to those whose Oxygen levels would be 84-85 or lower. However, many hospitals are now using this injection as a quick fix, administering it to patients immediately after they are admitted, so that they can be discharged soon,” Khivasara told Indie Journal.

The Pune Collector has also issued a notification asking hospitals to make rational use of the medicine. In the notification issued on April 5, 2021, the Pune District Collector Dr Rajesh Deshmukh has stated that the hospitals must treat patients as per the Clinical Management Protocol: COVID19 by the Union Ministry of Health and Family Welfare. The notification also adds that Remdesivir must be administered only when absolutely necessary.

While the relatives of patients who are admitted at different COVID centres have been running around the city from one distributor to another, most major hospitals in the city have said that they have sufficient stock for the patients admitted with them as of now. “We have over 400 COVID patients right now, and we have Remdesivir vials available for them,” Dr Murlidhar Tambe, Dean of BJ Medical College and Sassoon General Hospital said. 

However, while earlier patients from elsewhere could buy Remdesivir from Sassoon, they are not available at Sassoon’s medical store now. “The stock is not available in excess. Whatever vials are available, they are used for the patients admitted at Sassoon’s COVID ward. So Sassoon is unable to provide it to other patients,” a doctor at Sassoon General Hospital said.

Confirming that Remdesivir is used early on and more frequently than before, Dr Prakash Koyade who works at the Yashwantrao Chavan Memorial (YCM) Hospital in Pimpri said, “When the number of cases surged all of a sudden in the second wave, almost every patient who was hospitalised was administered Remdesivir immediately after testing positive. The cases were rising suddenly, hospital beds were limited and pressure was high. With new 100 patients getting admitted each day in the last 10 days, the available stock of Remdesivir exhausted quickly.”

Meanwhile, people are helpless as the hospitals are prescribing them four to six vials of Remdesivir for their patients, and it is available hardly anywhere in the city. On Thursday, at least 200-300 people waited outside the distribution centre of the Chemist Association of Pune District for almost the entire day, with hopes that the stock will be available. 

Similar queues were seen outside the medical store of Poona Hospital as well. “People are desperate and helpless. They get angry when we tell them that the medicine is not available in our stock. On Wednesday night, there were over 150 people outside, and we didn’t have Remdesivir. We were afraid that the crowd was going to get aggressive. We understand their plight, but we were just as helpless. We think we might need to ask for police protection if the situation continues,” said one of the employees at a distribution centre on condition of anonymity.