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    How Indian pharma companies should have dealt with Remdesivir crisis

    Synopsis

    Incidentally, pharma companies have been conspicuous by their silence, busy making hay while the sun shines. Except for disseminating helpline numbers or web-links to check the availability of the medicine stock — measures that haven’t helped much during the peak of the second wave —the companies did little to stem the crisis. Instead, they became part of the problem as they faltered in their role of patients’ outreach and doctor education.

    Agencies
    GoI now supervises the allocation of remdesivir to all states
    Kiran Kabtta Somvanshi

    Kiran Kabtta Somvanshi

    Dr. Kiran Somvanshi has been a part of the Economic Times Intelligence Group, the research wing of ET for over 15 years now. Telling insightful, data-backed stories is her forte either through analysis, opinion pieces or hosting podcasts. She actively comments on issues concerning ESG, Corporate Governance, Investor Protection, Public Health, Gender and Corporate Social Responsibility and tracks Pharmaceuticals and Consumer Goods sectors. Kiran has a PhD from TISS and is a qualified Company Secretary, Cost Accountant with a bachelor's degree in Law and Psychology. She is a Salzburg Global Fellow, Fulbright Humphrey Fellow as well as a Chevening Fellow. She has had short stints with the World Bank, UNDP and collaborated on research in the Brookings Institution. Twitter handle: @Kiran_ET

    It is rare for a pharmaceutical drug's generic name to become so commonplace among households in a short span of time.

    Thanks to the Covid-19 pandemic, the antiviral medicine remdesivir has become such a drug. Right from issues about its efficacy for the treatment of Covid to its shortage, black marketing, price escalation and a drug recall incident, remdesivir has earned itself a bad name, becoming one of the most controversial drugs in the Indian pharmaceutical industry.

    Just before the second wave hit, seven companies in India were together manufacturing around 38.8 lakh vials of remdesivir a month. In March 2021, as demand ebbed, Cadila Healthcare reduced the price of the drug from Rs 2,800 to Rs 899 a vial, the lowest in India. As the second wave kicked in, the demand for the drug soared — spurred by people stocking up the drug for contingencies.

    By mid-April, the National Pharmaceutical Pricing Authority had to put a cap on its prices at Rs 3,500. However, that did not prevent the drug’s price to soar manifold in the black market. Social media has since been full of requests by family members and loved ones of critical Covid patients desperately seeking the drug. Right from the illegal sale of the drug to its illegal manufacturing, unscrupulous opportunists have jumped in to make quick money on the fly. Profiteering, especially, in the healthcare business is worth special contempt, since human lives are at stake.

    Far from being a panacea, remdesivir is not a universally prescribed drug for treating Covid. While drug regulators in the US and Europe have validated it for Covid treatment, last November, the World Health Organization (WHO) recommended against the use of remdesivir in hospitalised patients, regardless of the severity of Covid, since it found no evidence about the drug’s efficacy to treat the disease. Even as medical professionals in India continue to exhort the dangers of irrational use of remdesivir — and the aspect that the drug proves efficacious for only a small percentage of Covid patients — the drug continues to be popular in treating the disease.

    Take Stock of Stocks
    Incidentally, pharma companies have been conspicuous by their silence, busy making hay while the sun shines. Except for disseminating helpline numbers or web-links to check the availability of the medicine stock — measures that haven’t helped much during the peak of the second wave —the companies did little to stem the crisis. Instead, they became part of the problem as they faltered in their role of patients’ outreach and doctor education.

    In a country like India with questionable public governance, it is the private sector that is often looked at as the torch bearer of the best practices. However, this time, not only has the government been caught unawares and unprepared for the second wave, but the industry too.

    What could the industry have done better? Maintaining transparency tops the list. Structured and coordinated communication on vials manufactured and distributed, as well as stock levels in the supply chain, could be made available real-time to the public through a digital platform. This would help improve access by servicing areas that are running short on the drug. An alert mechanism could be in place to escalate any anticipated shortage in raw materials to state and central governments.

    Empower Patients

    Spreading awareness about the efficacy and safety issues concerning remdesivir would also help empower and inform patients and their families. Rationing the sales and seeking patient information at the point of sale could be another measure of inhibiting the hoarding and black marketing of drugs. Pharma companies not having digitalised supply chains is costing patients dearly. It also leaves room for supply chain malpractices to continue unabated. A digital supply chain could minimise, if not eliminate, the scope of profiteering and instances of counterfeit drugs.

    In 2018, Niti Aayog had announced piloting a real-time drug supply chain using blockchain and Internet of Things (IoT) software, to tackle the problem of counterfeit drugs. However, there has been not much progress by government or industry on this front. People paying heavily inflated prices for buying a fake drug to treat their loved ones in critical condition can never be compensated for.

    GoI now supervises the allocation of remdesivir to all states. Thanks to overseas medical assistance, imports and beefing up domestic production, remdesivir will soon be more easily available and the period of scarcity will soon be forgotten. The only hope is that the lessons learnt are imbibed in standard operating procedures and become industry best practices.

    Views expressed are author's own

    The Economic Times

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