Is Remdesivir a life-saver, what’s causing a shortage?

NAGPUR: Remdesivir has arguably become the most searched drug, especially in the last 10 days after the state started facing acute

shortage

of this injection. However, there is a difference of opinion among doctors regarding the use of Remdesivir.

Those who support use of Remdesivir believe it is a life saver for Covid-19 patient while others oppose the “rampant use” of the drug. TOI spoke to pharmacists, treating doctors and health experts on how useful the injection is, and the reason behind its shortage.

Remdesivir is a broad-spectrum antiviral medication which is administered via injection into a vein.

“It was originally developed to treat hepatitis C. Later, Remdesivir was effectively used for Ebola virus disease. As novel coronavirus started spreading, the medication was studied as a post-infection treatment for Covid-19,” said pharmacist Dr Vikram Ghodeswar.

During the first wave of the pandemic, Remdesivir was approved or authorized for emergency use to treat Covid‑19 in around 50 countries. In India, the Drug Controller General of India (DCGI) has approved only emergency use of this injection.

Dr Sushant Meshram, head of Pulmonary and Sleep Medicine department of the Super Specialty hospital in Nagpur, told TOI that Covid-19 patients suffering from mild to severe disease have benefitted from Remdesivir in the first five days.

“Injections can be given daily for one to five days. But if the patient is getting serious even after that, the treating doctor can continue the dose for a maximum of 10 days. However, this injection should be used with caution in patients with kidney disease,” he said.

Remdesivir was given to 15 to 20% patients during the first wave which roughly ended in October 2020. Updated guidelines from the World Health Organization (WHO) in November 2020 recommended against the use of Remdesivir for the treatment of Covid-19. So, it was expected that the use will reduce. Surprisingly, Remdesivir is now being used on 80% patients, especially at

private hospitals

.

“It does not fit into the standard protocol but private hospitals are still using it exponentially,” said health minister

Rajesh Tope

while speaking with media on Monday about the reasons behind shortage of the drug. “Currently, doctors and hospitals are prescribing the injection even for those suffering with mild problem of breathlessness,” said Tope adding that it’s a violation of the protocol.

After getting five to seven doses of Remdesivir, the patient’s bill to increases. Currently, the health department does not have a system to check whether every patient really needs this injection. The treating doctor is the only authority to decide. This has created a shortage.

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