A drug for Rs 4,000 being sold for as much as Rs 60,000. That is the story of how rampant black marketing of essential medicines for Covid-19 has become In India. The warning against black marketing of remdesivir has come from the top drugs controller, but it continues right under the nose of authorities.
Gilead's remdesivir, sold under the brand name Cipremi by Cipla, Covifor by Hetero and Desremtm by Mylan, costs anywhere between 4,000 and 5,400 rupees in the market provided it is sold fairly. But the trade practices are far from clean.
Remdesevir has been granted import licenses by the drugs authority in India, acknowledging that the medicine is yet to be imported. It is in this context that Indian companies were given the permission to manufacture and sell this drug which has been granted emergency use.
News18 spoke to the relative of a patient who needed 7 vials of remdesivir. The patient is recuperating in a top Delhi hospital. "There is rampant black marketing, there is a cartel running," the relative of the patient told us on the condition of anonymity.
"The system is so exploitative, I went to Yusuf Sarai market and I was told, today the going rate for remdesivir was 37,000 rupees. The day before it was 25,000," said the relative. "I checked with chemists in East, South and West Delhi and got similar responses. It is a cartel."
Community forum LocalCircles had written to the health ministry, saying that instances of black marketing were being reported and overpricing of the medicine was rampant in Delhi.
Acting on the complaint, the Drugs Controller General of India, VG Somani, in a terse letter had asked state drug regulators to ensure black marketing of remdesivir, a drug granted emergency use, does not happen. The letter was written earlier this week.
That there is a serious shortage of the drug is no secret now. It is also being misused, is what leading doctors are saying. A source at Hetero Drugs, that sells, manufactures and supplies remdesivir under the brand name Covifor, said there indeed is a shortage. "However, we will be able to deliver one lakh vials by August end," he said, again not wanting to be identified.
"We have been in touch with Cipla and also with Hetero. Every day, I get calls for remdesivir, but there is no supply in the market," said Ashish Grover, general secretary of the Delhi Drug Traders Association.
Dr SK Chhabra, head, department of pulmonary, sleep and critical care medicine at Primus Hospital, said the medicine is being misused. "This is not a magic bullet. It is being used for severe patients, those with moderate illness. It should only be used early in the disease," he said.
Cipla has just launched remdesivir under the brand name Cipremi. It costs Rs 4,000 a vial. The Drug Controller General of India has granted permission to Mylan to manufacture and market remdesivir for "restricted emergency use" on hospitalised Covid-19 patients. Mylan is to launch its generic remdesivir version in India at Rs 4,800 a vial.
Mylan's remdesivir will be launched around July 22-24. The intended capacity is of 2,70,000 vials per month. Cipla too has plans to boost production of the drug which is high on demand now. The government says by the end of this month, India could be producing over 20,000 vials of remdesivir per day. This is an estimate of the Central Drugs Standard Control Organisation.
It is important to understand, however, that remdesivir is a medicine still under the category of investigation therapy, says the government. At a press conference on Thursday, Rajesh Bhushan, special secretary, ministry of health and family welfare, said that companies manufacturing and selling remdesivir have been asked to put in place a 24/7 helpline number.
"They must proactively put on their website the details of their distributors and their supply lines so that all confusion and anxiety in the market subside," he said.
The health ministry this month reduced the dosage of remdesivir without citing any reasons, but several medical practitioners linked the drug to liver toxicity. The DCGI has also directed state governments to instruct drug inspectors to ensure that there is no black marketing of medicines being used in treatment of Covid-19 patients.
Distributors are on the defensive. They say that indigenous companies are selling directly to hospitals. Chemists could have possibly procured it by importing it. "We will cancel the membership of the member who is found to be doing this," said Rajiv Singhal, general secretary, All India Organisation of Chemists and Druggists.