Maharashtra: Avoid Remdesivir-like mess with new Covid-19 drug, says MRPA chief

NAGPUR: Drug Controller General of India (DGGI) has given restricted, emergency use approval to ‘Virafin’ injection from Zydus Cadila. The company has claimed the drug is very effective on Covid-19 and brings down viral load significantly in seven days, with guaranteed negative RT-PCR after that. It is claimed to be a game-changer. It will be taking place of Remdesivir in next few days. However, the present mess of distribution of Remdesivir has created havoc for patients as well as for doctors. If the same faulty distribution system is followed, it will encourage black-marketing of this new medicine too, warned Kailas Tandale, president of the Maharashtra Registered Pharmacists Association (MRPA). He suggested distribution of this drug should be done the traditional way through pharmacists.
Q: Is Virafin really effective on Covid-19?
A: Zydus Cadila has provided data that show it is. It is the first drug in India specially formulated for Covid-19 treatment. It has the same approval like Remdesivir. So, we can consider this as a good, specialized and effective medicine.
Q: Do you think there will be a surge in its demand like Remdesivir?
A: Of course. I think the Remdesivir mess was avoidable. The drug was available in good quantity but faulty distribution system added to the trouble after the demand increased. MRPA has proposed the traditional strong drug distribution system should be used at least while distributing ‘Virafin’ so that the mess is not repeated.
Q: What is the traditional distribution system?
A: Remedivir falls under Schedule H. Virafin will also be included in Schedule H. A pharmaceutical company first gives their products to Clearance and Forwarding (C&F) agent. It is then dispensed to wholesalers at district-level. From them, it goes to wholesaler and to retailers. C&F supplies drugs only to licensed wholesalers. It is controlled by the FDA. This is the traditional way.
Q: What went wrong in case of Remdesivir?
A: Remdesivir used to be distributed through the traditional channel earlier. As demand increased, the distribution was shifted to district collector to prevent its alleged black-marketing. Office of collector lacks manpower. It is difficult for them to manage distribution. They hand over injection to private hospitals but no one ensures it is given to the needy patient and not sold elsewhere. Today, neither doctor nor pharmacist, but government officers are deciding whether your patient needs Remdesivir or not. This should not happen in case of the new drug.
Q: What according to you, will be the ideal distribution system?
A: There are 9 lakh medical stores in the country; 80,000 drugstores are in Maharashtra; 700-800 medical stores in every district and 100 medical stores in a tehsil place. The government can appoint any 20-25 medical stores at tehsil-level for distribution of such drugs. They will further distribute the drug. They have to account for each vial to the FDA.
Q: Will this stop black marketing?
A: Open sale is the best way to stop black marketing. Doctors will prescribe the injection and it will be available in select 20-25 distributors who will keep account of sale. Instead of passing the load to revenue department (collector) government should fill up 50% vacant places of drug inspectors to keep check on drug distribution.