The utter chaos and confusion over Remdesivir in India is making the COVID-19 second wave worse

• Doctors are prescribing Remdesivir despite its uncertain impact but patients and kin are willing to try anything which gives them a ray of hope.
  
  
• The demand has gone through the roof and manufacturers are struggling to keep up.
  
  
• Bad folks are using the time to take advantage of the truly desperate as more patients queue up and the vicious cycle perpetuates.

Remdesivir is not a proven treatment against COVID-19. Governments have said it, the courts have said it. Even the World Health Organisation (WHO) has said and reiterated this fact. Yet, in India, people are rushing to the pharmacies and hospitals with prescriptions for the drug leading to a crunch in its supply.

“People are buying Remdesivir because that’s what the doctors are prescribing,” Pragati Medical, a pharmacy in Hyderabad, told Business Insider. As COVID-19 claims more victims in its second surge, Remdesivir⁠ — currently a drug of last resort against the novel coronavirus⁠ — has become a hot property with its own black market where it could cost, sometimes, up to five times the price.

Even Twitter is awash with people requesting vials of the drug to treat their loved ones currently in intensive care units (ICUs). Communication along the supply chain, from the manufacturers to the end consumer, has a lot left to desire and is adding to the chaos.




The Indian government has been unable to include the Remdesivir injection under the Drug Control Act because it has not completed its clinical trials to establish its efficacy in treating COVID-19.

Yet, doctors are prescribing it indiscriminately. “You should advise doctors not to prescribe the drug unless it is required,” said the Gujarat High Court on April 15, during a hearing about the surge in COVID-19 cases across the state.

According to the court, the state needs to explain what the drug is, when to use it, where it should be procured, and whom it should be given to. “I don’t know whether it is a life-saving drug. But it has unnecessarily been seen as an Amrit [elixir],” the court said.

Who is creating the hype behind Remdesivir?
In the Gujarat High Court hearing, Justice BN Karia asked the attorney general if the hype behind Remdesivir was being created by the doctors. And that’s a valid question to ask. However, doctors may not have many options in hand for patients desperate to be healthy again.


“In the absence of any effective documented drug, what is the option left with doctors,” justifies Gulshan Haresh Bakhtiani, the founder of Wellness Forever, a chain of online pharmacy and medical stores.

But he does admit that there is a shortage. “Shortage is there not because doctors are prescribing the drug. The shortage is there because manufacturing is not adequate,” said Bakhtiani.


But the supply crunch is expected to ease up in the coming days. There are currently seven manufacturers of Remdesivir in the country — including Zydus Cadila, Dr Reddy’s Laboratories, Sun Pharma, Viatris, and Cipla, who have all issued statements to the effect of increasing production in the face of rising COVID-19 cases.

“Remdesivir is not in as much short supply as it was four or five days ago. We have a good number of manufacturers in India and around seven days back, all of them increased manufacturing of the drug,” Bakhtiani told Business Insider.

Pharmaceutical companies say they have increased production — but the goods are yet to reach the end of the supply chain
“Right now Remdesivir is not available anywhere — there’s not even a single injection,” a manager at one of Haryana's medical wholesalers, Allied Medical Agency, told Business Insider. “It's not available in Hisar. It’s not available further inland. I have even spoken to people in Delhi and Chandigarh, there is no supply.”

But that isn’t keeping people from offering up empty promises. In the case of Allied Medical Agency, the coordinator got in touch with someone willing to supply vials of Remdesivir for ₹4,800 apiece, almost five times the maximum retail price (MRP) of ₹900.

In cross-checking the details before he made any payment, his other contacts informed him that the source is unlikely to have the stock — the source more likely to take the money but will only deliver the goods after a long period of time.


The silence at the end of helplines
Bigwig medicine manufacturers have also set up helplines to help people ascertain where they can procure COVID-19 drugs. However, when Business Insider called the Cipla helpline — not once but twice — there was nothing but a pre-recorded message that played on a loop for over five minutes, before the call was abruptly ended.


The company did send an SMS to say that the call had been noted but they were unable to attend because their assistants are busy attending other patients, but no follow up has occurred since then.

In the absence of a proven cure, patients would take anything that could possibly save their lives. So, doctors are prescribing Remdesivir despite its uncertain impact. The demand has gone through the roof and manufacturers are not able to keep up with the required pace to meet the demand. Bad folks are using the time to take advantage of the truly desperate. Meanwhile, more patients are queuing up and the vicious cycle perpetuates.

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