Drugs for Covid patients

Government allows profiteering by pharmaceutical companies

Vital drugs for treatment of Covid patients are in short supply and priced at levels that masses of people cannot afford. Pharmaceutical companies are taking advantage of their monopoly over these drugs and profiteering. The shortage has led to black-marketing of some of these drugs at absurdly high prices. The Indian government has neither planned for the availability of drugs in adequate quantity to deal with rising number of Covid-affected patients nor is it using the powers it has to make these drugs available at affordable price.

For the tocilizumab injection, patients are being forced to spend as much Rs. 1.4 lakh for one vial of 400 mg which is supposed to cost around Rs. 40,000, a price which cannot be afforded by most patients. Yet, in their desperation to save lives of their near and dear ones, people are searching for it all over the country due to the shortage. On the night of 9 July, 500 people lined up in front of a shop in Mumbai on learning of the availability of the drug.

This drug is a worldwide monopoly of the Swiss pharmaceutical multinational, Roche. In India Roche has allowed its import and distribution by only one Indian drug company, Cipla. This keeps the price of tocilizumab high and the supply limited, while families in distress struggle to procure it.

Similar is the experience of people with another drug, remdesivir, which is being sold at as much as Rs. 60,000 as against its MRP (maximum retail price) of Rs. 4,800 to Rs. 5,400 per dose, depending on the company marketing it. This drug is the monopoly of the US pharmaceutical company, Gilead Sciences. Two Indian drug companies, Cipla and Hetero have been licensed to produce and sell it in the country.

Another drug, favipiravir, is sold for Rs. 103 per tablet and the entire treatment could cost about Rs. 12,500. The drug is locally developed and produced by the Indian company, Glenmark.

Seriously ill Covid-19 patients will often be given many of these drugs, either one after the other, or simultaneously, making the overall price of treatment unaffordable for most patients of the country.

A study analysed the cost of production for these drugs for Covid, including tocilizumab, remdesivir, and favipiravir. The actual cost of production is extremely low.

The government has the powers under Drug Price Control Order (DPCO) to regulate the prices of drugs used in the treatment of Covid. The DPCO provides the government extraordinary powers to fix the prices of drugs in important or emergency situations. It, however, has not used any of these powers in this unprecedented public health emergency to prevent profiteering by Indian and multinational pharmaceutical companies.

India is considered a leading country in pharmaceuticals, with the technical capability to mass produce all the drugs currently being used for treatment for Covid patients. The Central government should use its power to issue compulsory licenses which would allow generic drug producers in the country to produce them cheaply.

The central government has failed in its duty to ensure availability of drugs for Covid treatment at affordable prices. Its failure is bound to lead to many avoidable deaths and push many other families under the burden of huge debts for life.

At the same time as the Drug Controller General of India (DCGI) has approved these drugs for application to Covid-19 patients, there remains a lot of uncertainty about their efficacy. More seriously, there is uncertainty about the harmful effects they may have if not administered under very strict protocols regarding the stage of the infection in a patient, the particular conditions of the patient, etc. The Indian Council of Medical Research (ICMR) and All India Institute of Medical Sciences (AIIMS) have cautioned against the use of these drugs except under emergency. Even now, the DCGI has not shared the data with the WHO on the basis of which the drugs have been cleared. Public health experts have also questioned the scientific basis of its approval. The lack of unanimity among the leading medical and drug control authorities forebodes a dangerous situation for the people.