Tauseef Ahmed, a volunteer in Bengaluru has been inundated with phone calls this week from people looking for Remdesivir, an antiviral medication administered to COVID-19 patients. "I am fielding 20 calls every day for the past week from patients and their relatives looking to source Remdesivir. Until three days ago, the patients were mostly from smaller hospitals but in the last three days, even patients from larger corporate hospitals are looking for this drug," says Tauseef speaking to TNM.
Tauseef is working with the Emergency Response Team (ERT), a group helping COVID-19 patients find hospital beds and access to medicines in Bengaluru. He says that alongside the demand for hospital beds, the city's private hospitals are facing an acute shortage of Remdesivir.
According to Dr Rajashekar YL, Secretary, Private Hospitals and Nursing Homes Association (PHANA), there are currently around 1000 vials of Remdesivir in Bengaluru hospitals while the requirement is close to 12,000. "We raised a request for 12,000 vials for various hospitals in Bengaluru yesterday (Wednesday) and we procured close to 1000 vials. A hotline has now been opened for hospitals to flag requests for Remdesivir," Rajashekar tells TNM.
Rajashekar's claim is corroborated by administrators at Bengaluru hospitals including St John's Hospital in Koramangala. "There is a shortage of Remdesivir in our hospital. We have 96 COVID-19 patients including 15 patients on ventilators and we have about 26 vials of Remdesivir. The supply of the drug has been erratic in the last three days," says Dr. Sanjiv Lewin, Chief of Medical Services, St John's Hospital. Another hospital, Santosh Hospital in Pulikeshi Nagar, also reported a shortage of the drug.
Despite the appeals from hospital administrators, Karnataka Health Minister K Sudhakar denied that there was a shortage of Remdesivir in the state on Thursday. "In Karnataka, there is no shortage of the drug for those patients in government hospitals or those who are referred to private hospitals by the government. A team has been notified to ensure the availability of the drug to even those admitted in private hospitals," said Karnataka Health Minister K Sudhakar, speaking to reporters. He claimed that the drug is manufactured by three companies in the state and that there is adequate stock available at present.
The shortage was limited to private hospitals and was not reported in government hospitals in Bengaluru. At least three government hospitals - Victoria Hospital, Jayanagar General Hospital and CV Raman General Hospital - in the city reported that they have adequate stock of the drug.
In Karnataka, unlike some other states, Remdesivir is directly administered to the patient in the hospital and it is not available over the counter in medical stores. The Karnataka government supplies the drug to private hospitals when patients are referred to the government through the Suvarna Arogya Suraksha Trust (SAST). Each patient is administered six doses of the 100 mg injection. Of this, two doses are given on the first day, followed by one dose each for the next four days.
According to doctors, Remdesivir is an injection that helps COVID-19 patients if it is administered at the right time. Its popularity is one of the reasons for the shortage of the drug this week. It has prompted patients and their family members to source the drug themselves.
"Every call made to the emergency team is someone in distress and they are looking to source the drug. They are being quoted very high prices by hospitals and medical stores, as high as Rs 20,000 in one case from Bidar," says Tauseef. The price of the drug varies between Rs 899 and Rs 5400.
The issues in the supply of Remdesivir are linked to the slow down in the production of the drug towards the end of 2020 when COVID-19 cases dipped in India.
The Union government on Tuesday flagged the indiscriminate use of the drug and urged physicians to be judicious in their use of it and only use it on COVID-19 patients on oxygen support. The Union government also fast-tracked approvals to raise the production of the drug by 10 lakh vials per month. Manufacturers of the drug also committed to reducing its price to less than Rs 3500 per vial by the end of this week. The Union government has also stopped the export of the antiviral injection and its Active Pharmaceutical Ingredients (API) till the situation improves.
Bengaluru reported 8,155 COVID-19 cases on Wednesday, the highest single-day spike since the onset of the pandemic. The cases in the city are expected to peak in May and hospitals in the city are hopeful that their requests for Remdesivir will be fulfilled in the next week.