Remdesivir to Itolizumab: How effective are the drugs for Covid treatment?

Remdesivir costs around Rs 5,000 per vial with a total treatment cost in the range of Rs 35,000-50,000.

The Central Drugs Standard Control Organisation (CDSCO) has approved five drugs in the last month for Covid-19 treatment – two antiviral: Remdesivir and Favipiravir – and three for easing the symptoms: Dexamethasone, Tocilizumab and Itolizumab. These drugs’ use is bound to birth complications considering there are doubts about the evidence the government has furnished – or not – to approve their use.

Remdesivir costs around Rs 5,000 per vial with a total treatment cost in the range of Rs 35,000-50,000. Favipiravir costs Rs 103 per 200 mg tablet; the total treatment cost ranges from Rs 12,000 to Rs 15,000. A vial of Itolizumab costs around Rs 8,000 and the total treatment cost could be between Rs 32,000 and Rs 50,000. Tocilizumab costs Rs 40,000 to Rs 50,000 per vial.

Remdesivir

Remdesivir was approved for clinical use for both children and adults by the CDSCO as an injection on June 1, amid controversies surrounding its efficacy. This drug is manufactured by Gilead Sciences Inc. The first randomised double-blind study showed no statistically significant treatment efficacy in severe Covid-19 patients. Gilead’s own study reported that no fewer people died when on the drug. However, while the study also reported patients on Remdesivir recovered four days earlier on average, independent experts aren’t convinced.

A press release by the US National Institute of Arthritis and Infectious Disease (NIAID), the study’s sponsor, nonetheless said hospitalised patients with Covid-19 recovered faster when they were on Remdesivir compared to placebo. There was also a controversy surrounding the changing of end points of the study, to get a favourable outcome. Gilead’s quest to secure approval for the drug were also shadowed by reports of lobbying to influence the FDA and other authorities.

Covid-19 impact: Hydroxychloroquine's share in pharma exports minuscule

Manufacturers say there is enough stock for local needs.

India, the world’s largest producer of hydroxychloroquine (HCQ), exported $51 million worth of the drug in FY19. This was a minuscule portion of the country’s $19-billion pharma exports.

In FY20, however, exports had dipped to $36 million till February. With US President Donald Trump campaigning for HCQ, global demand for the inexpensive drug has surged all of a sudden. Countries like Brazil and India’s SAARC neighbours have sought the drug from India.

The Centre itself has requisitioned 100 million tablets from Ipca Laboratories and Cadila Healthcare. Manufacturers claim there is enough stock for the Indian market, and that the surplus could be exported. They are gearing up to supply the same to the government within this month.

Further, China does not make HCQ and India is the lead global supplier, they add.

HCQ and chloroquine phosphate are in the same class of drugs. Chloroquine is an anti-malarial used to prevent and treat malaria.

HCQ, on the other hand, is used to treat auto-immune disorders like rheumatoid arthritis, lupus, and as a third-line treatment for diabetes.

Some health researchers have used HCQ, along with a combination of a common antibiotic azithromycin, as a potential treatment for Covid-19. In a government advisory, India recommended the use of HCQ for healthcare workers and high-risk individuals to prevent contracting the infection.