The crisis the world is facing is too devastating to encounter daily and the Ray of hope in this pandemic is Remdesivir injection but its sudden shortage has left the world disappointed and worried. Today 140,886,773 cases were confirmed and 3,012,251 people died, India being at the top. Remdesivir is an injectable antiviral that prevents the replication of SARS-CoV-2 and it was manufactured in 2014 to treat ebola and in 2020, it was repurposed for covid-19 treatment of adults and adolescents weighing a minimum of 40 kg (88 pounds) of the age of 12 and above.

Like the previous year, 2020 for shockingly scary the second wave is unimaginable and the condition is way worse than the first one. If these numbers will keep increasing then the whole world will become a hospital and the deaths will be uncountable.

EFFECTS OF REMDESIVIR

It’s best on Mildly ill patients and on patients who have been hospitalized in their early stages of infection. Severely affected patients have less effect of this antiviral remdesivir.

STATES AFFECTED

At present several states like Maharashtra (which gets 70% of the total remdesivir ), Delhi, Gujarat, Chhattisgarh and Madhya Pradesh reported a shortage of remdesivir injection.

Maharashtra(worst hit)-11 lakh active cases and 70% of the total remdesivir production goes to Maharashtra but the state is getting only 30% of what they need from this year. There is a shortage of 70% Remdesivir in Maharashtra.

Comparing to last year when Maharashtra needed 30,000 Per day they now need 40,000-50,000 vials this year.

The sudden increase in cases and 70% shortage is fading the only ray of hope people had.

WHY THIS MUCH SHORTAGE? 

The Directorate of foreign trade in the Ministry of Commerce and industry ordered the prohibition of the export of remdesivir and active Pharmaceutical ingredients(API’s) which is required in its production, until further notice.

The food and drug inspector in Maharashtra said “if we need 7000 Remdesivir vials per day we are getting 1500- 2000 only”.

DECREASE IN PRODUCTION OF REMDESIVIR

In November 2020, covid cases were decreasing and due to that suppliers and manufacturers had huge stockpiles left with them. So the production of Remdesivir vials was negligible in the last three months of 2020.

According to the former joint committee(FDA) of Maharashtra, the suppliers had to destroy stocks that were expired. The manufacturers scaled down the production to 5-10%.

From January 2021 Kamla Lifesciences, supplier of Remdesivir of Cipla stopped manufacturing from January last to march starting of 2021.

Dr DJ Zawar, MD in  Kamla Lifesciences said, “government asked us to scale down the production as covid-19 cases were reducing and its demand was decreasing as a result.

And this has affected India very badly where the needs are not getting fulfilled.

THE CURRENT SITUATION

Covid-19 cases started to rise from February 2021 but production started in March 2021, ONE MONTH GAP, where in the world every hour thousands of people are dying, one month of negligible production of the life saving antiviral remdesivir’s impact is in front of us.

“We need at least 25 different raw materials in the production of Remdesivir, we have to obtain a lot of raw materials urgently but our supplier could not supply this much quickly due to this halt” said Prafulla Khasgioal senior VP hetero Healthcare.

The change from production to transportation to delivery to the patient can take up to 20-25 days, so it will take another one week for new stocks to come into the market since the production scaled up last month only.

DEMANDS FROM MANUFACTURERS

We have 7 manufacturers in our country to scale up the production as much as possible. and they had to manufacture 38.80 lakh Remdesivir vials per day as asked them by the department of pharmaceuticals.

They are

  1. Hetero
  2. Cipla
  3. ZydusCadila and
  4. Mylan 
brandproduction
Hetero10.50 lakh
Cipla6.20 lakh
Zydus Cadila5 lakh
Mylan4 lakh

Kamla Lifesciences is going to manufacture 90000-95000 liquid Remdesivir per day.

Zydus has reduced the price of its Remdesivir vials brand named ‘Remdac’ by 65% from Rs.2800 per mg vial to Rs.899 per mg vial, which made it affordable to people.

 Zydus planning to produce 12 lakh vials per day. Hetero is currently manufacturing 35000 vials in a day or two.

Brand nameCost of a vial
Zydus899
Cipla 4000
Hetero5400
Dr Reddy’s lab5400
Mylan4800
Jubilant4700

All of the above company’s CEO or spokesperson said to scale up production to meet the demands of the country and supply it as fast as they can.

Mylan spokesperson said, “we are closely partnering with the Government of India to meet the needs of this country.”

OVER-USAGE OF REMDESIVIR

AIIMS chief said, “remdesivir isn’t a magic bullet”,

in India remdesivir’s over-prescription has amplified its price and its overprescribed to even those people who will not be benefited from it and the worse thing is, the patient will become resistant to this antiviral drug.

FRAUD CASES

Recently in Pune 4 people held for selling Paracetamol liquid in remdesivir injection vial for Rs.35000.

WEBSITES FOR HELP

Some websites are there to assist patients with Hospital beds, remdesivir injections and oxygen cylinders and the websites are-

For the information related to plasma donors, websites are-

Here is a doc link for a collection of covid resource support from various parts of India:- https://docs.google.com/document/d/e/2PACX-1vQLa5IUS7JfyoxIOWY53QWKgwFKko542K6lJpWkEq7oZRM79Y1H92YZNUZTOrFhWK2n3P6admdwU8YH/pub

To check hospital bed availability in Bangalore kindly refer to this linkhttps://docs.google.com/spreadsheets/u/1/d/e/2PACX-1vS-ipQLaCHZ8id4t4_NHf1FM4vQmBGQrGHAPFzNzJeuuGKsY_It6Tdb0Un_bC9gmig5G2dVxlXHoaEp/pubhtml?gid=1381543057&single=true

The government have ordered to take action against black marketing and hoarding of Remdesivir and it is advised to the hospitals to use anti-viral Remdesivir according to the national covid protocols, which list remdesivir as an investigational drug with a contraindication.

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