Remdesivir shortage: what lies ahead and modus operandi of handling it

Remdesivir, the anti-viral drug that is given in form of injection, is running low in quantity. As Covid-19 surge leading to the second wave of infections in the country is stressing healthcare infrastructure, the anti-viral drug that prevents virus replication, forms an avid part of the treatment protocol of a Coronavirus positive patient. 

Maharashtra, Gujarat, Delhi, Chhattisgarh and Madhya Pradesh have reported diminishing stocks of Remdesivir. Citing the development, on Sunday, the Directorate of Foreign Trade in Ministry of Commerce and Industry has issued an order that would prohibit export of the drug and active pharmaceutical ingredients (APIs) that are required for production of Remdesivir. 

Remdisivir was manufactured in 2014 to treat Ebola. Since then it has been used to treat SARS and MERS. In 2020 it was repurposed for treatment of Coronavirus infection. The anti-viral has evidently shown to work better in mildly ill patients and in early hospitalization stages. Use of drug later in course would have little effect. 

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After last year in December, when huge stockpiles were left with remdesivir’s suppliers and manufacturers, this year for 2-3 months the drug’s production was close to nil. As the cases surged this year, the demand for Remdesivir too sky-rocketed overwhelming the whole supply-demand cycle. Last year due to low supply, many manufacturers had to destroy the expired drugs, leading to lower production this year. 

Seven companies including Hetero Healthcare, which is the largest manufacturer of Remdesivir in the country, and Kamala Lifesciences have been asked by the Department of Pharmaceuticals to scale up manufacturing of the drug to a maximum of 38.80 lakh vials per month. Hetero can produce 10.50 lakh, Cipla 6.20 lakh, Zydus Cadila 5 lakh and Mylan 4 lakh vials. 

On the flip side, it was noted last year that Remdesivir was being overprescribed to patients who would also not benefit from it. This was red-flagged by the Department of Pharmaceuticals. Price inflation has been mainly attributed to the over-prescription of the drug. States have been advised to take action against hoarding and black marketing. It might take a while for the supply-demand structure of Remdesivir drug to come back to sync, till then judicial use of the drug must be the way to go.