A Bengaluru resident was baffled when a doctor said her uncle, a patient of Mucormycosis, would need 50 doses of Amphotericin B injection. While the family somehow managed to procure the drug in such a huge quantity, not everyone is able to do so.
Besides the fact that Amphotericin B is in massive demand given the rise in Mucormycosis cases leading to a shortage, a vial of the drug costs anywhere between Rs 6,000 to Rs 8,000. When a patient’s family is asked to arrange anywhere between 50 to 100 vials as a complete course of treatment, one has to shell out about Rs 3- 4 lakh. The a life-threatening infection, among COVID-19 patients and those who recovered from it, is being reported in a large numbers from across the country.
While injections are usually prescribed in much smaller counts, like five or ten, the requirement of such huge number of doses for treatment of Mucormycosis infection has baffled many.
A senior doctor said that fungal infections are stubborn microbes and, hence, need long-term treatment. “These drug doses are calculated according to the body weight of the patient. One mg of medicine per kilogram of a patient’s weight is the general calculation. A patient is advised two to three doses per day depending on the severity of the infection and various other factors,” said Dr Srinivas Murthy, a senior consultant at Life Care Hospitals, Bengaluru.
There is another version of this drug, which is a lipid dominant one, called Liposomal Amphotericin. This version is 10 to 15 times costlier, but it is less nephrotoxic (toxicity of the kidney), Dr Murthy said.
While many critical patients in Karnataka have been prescribed 50 to 60 doses of Amphotericin B, the situation in Maharashtra is not very promising either. The state has the highest number of mucormycosis cases in the country with over 2,200 patients undergoing treatment at the moment. The state is also facing a shortage of Amphotericin-B like most other states. The central government has distributed the drug to several states, but the quantity is not adequate.
The Maharashtra government has floated a global tender to procure the drug and supply is expected to reach the state by June 1.