Some Russian hospitals face shortages of COVID-19 drugs

Some Russian hospitals are experiencing serious shortages of drugs used to treat COVID-19 and cannot restock because of panic buying, high demand and problems with a new labelling system, officials, distributors and doctors said. Russia, which has reported the world's fifth-highest number of COVID-19 cases, is -- like many other countries -- struggling to cope with a second wave of the disease and the healthcare system outside Moscow is close to breaking point.

Doctors in over a dozen regions face big shortages of antibiotics, antiviral drugs and other medicines used to treat COVID-9, three local officials and three drugs vendors told Reuters. "Head doctors call me every few minutes and beg for medicine. They have nothing to treat patients. And I have nothing for them to deliver," the co-owner of a large pharmaceuticals distributor said, on condition of anonymity.

Kremlin spokesman Dmitry Peskov said last week he was aware there were problems. "We know that there is a shortage in certain regions, this is unacceptable. The government is making very vigorous efforts to prevent this," he said. The health ministry did not reply to a request for comment.

A doctor from the Bashkiria region in south-central Russia said a hospital in her town was short of antibiotics because of the large influx of patients. She declined to be identified. With the number of COVID-19 cases recorded in Russia now above 2 million, social media feeds are full of requests to buy medicine.

"We don't have water for injections, let alone antibiotics and antivirals," an official from a Siberian town said on condition of anonymity. Russian doctors use a specific programme with specific drugs to treat COVID-19 patients. It includes the antibiotics Levofloxacin or Azithromycinum, and local antiviral drugs such as umifenovir, documents seen by Reuters show.

Those antibiotics and antiviral drugs are now running short, regional officials say. "There is a huge shortage of COVID medicine," said one senior regional official.

Only Moscow and some other wealthy regions have the financial and lobbying resources to tackle such shortages. "The only cure is to pray," said an official who works in a regional COVID-19 crisis centre.

SYSTEM FAILURE Details of the drugs used in the treatment programme have been shared on social media, causing panic buying which has emptied pharmacies and suppliers' warehouses.

Antibiotics should legally be sold over the counter only with a doctor's prescription, but many pharmacies sell them without one. Drug manufacturers are unable to increase production instantly, said Anatoly Tenser, development director at Katren, a large distributor.

Drugs producers are also experiencing problems importing substances they need from India and China because of high global demand during the pandemic, the co-owner of a large pharmaceuticals distributor said. Alexander Semenov, president of drug producer Acticomp, said the company faced shortages of imported reaction intermediates, which are used for producing drugs.

"Of course, there are shortages. In the summer, we made stocks for six months in advance. Unfortunately, they ran out very quickly," he said. Rustem Muratov, CEO of drug maker Binnopharm Group, said one of its factories had increased production of Levofloxacin by a factor of six, and of Azithromycinum by a factor of five in September compared to a year earlier.

"The manufacturers are not coping. There are just not so many of these drugs available," said a regional official from a COVID-19 crisis centre. A new drug-labelling system, introduced in October to counter black market drugs by electronically monitoring the movement of each drug from manufacturer to consumer, has not helped.

Teething problems mean manufacturers have faced difficulties putting drugs into the system and pharmacies have had problems with sales, several distributors and producers said. A Reuters reporter was unable to buy any drugs included in the treatment programme at over a dozen pharmacies in Moscow and witnessed the labelling system malfunctioning when trying to buy other drugs.

One supplier said he has been unable for several weeks to get a large shipment of dexamethasone, used to treat the new coronavirus, because of problems with the labelling system at the factory. "It was crazy to introduce this system, without testing, and during a difficult epidemiological situation," Nikolai Bespalov, the development director at RNC Pharma, said.