Vitamins, antivirals shortage piles woes on covid patients

Antiviral drug remdesivir remains the most sought-after medication in the scramble for drugs to treat acute covid-19, but stocks of several other key covid-related drugs are running low as well, posing a new challenge in India’s battle against the pandemic.

The explosive rise in coronavirus cases has dried up stocks of remdesivir at most of its seven manufacturers, prompting the government to ask companies to double capacity.

Meanwhile, antiviral favipiravir, immunosuppressant tocilizumab and multivitamins are also becoming scarce.

“There is already a shortage of favipiravir in the country, and multivitamins are also going to see a shortage soon because most mild patients are primarily given that to strengthen their immune response against the disease. By next month, there might be a shortage in most covid-19 drugs if this trend of the second wave continues,” J.S. Shinde, president of All India Organization of Chemists and Druggists (AIOCD), said over the phone.

Industry representatives said some of the top domestic drug makers have negligible inventory and are distributing almost everything that is being produced. In a statement on Monday, Glenmark Pharmaceuticals Ltd, which manufactures the favipiravir brand, FabiFlu, said it is working towards ensuring continuous supply of FabiFlu throughout the country, and its production capabilities have been ramped up to ensure availability of the drug in the market.

In a statement, Cipla Ltd, one of India’s top drugmakers with a wide portfolio of covid-related drugs, including favipiravir, azithromycin and multivitamins, said, “We are ramping up production capacities for all critical covid-19 related drugs.” Cipla has the largest portfolio of covid-19 related medicines in India and also is one of the seven manufacturers of remdesivir and the exclusive distributor of tocilizumab.

According to industry observers, supplies of tocilizumab, which is exclusively imported by Cipla from Swiss firm Roche, has completely dried up. The company said last week that it was facing a shortage of tocilizumab supply and was working closely with its partner to ensure its availability.

Industry observers said that capacity expansion is likely to take time, and even then, it may not be enough. India has seen a sharp increase in new covid-19 cases over the past month, especially in states like Maharashtra, Delhi, Uttar Pradesh and Chhattisgarh. On Sunday, there were more than 275,000 new cases, while more than 1,600 people died. India’s total confirmed covid-19 cases crossed 15 million, the second-highest in the world.

On the other hand, industry observers said that monitoring the availability of favipiravir, for instance, has been a low priority for the government as the drug is not part of the government covid-19 clinical management guidelines even though doctors continue to use it to treat coronavirus infections. “Their data in the treatment of covid-19 is not very strong. There is not much evidence to show in good robust studies that it is a good drug, and in most countries also, it is not being used,” Randeep Guleria, director of All India Institute of Medical Sciences in New Delhi, said about favipiravir at a press conference on Monday.

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