May 21, 2021 9:57:33 pm
Chemists in Maharashtra may soon find it hard to source Amphotericin B, now in high demand for Covid-19 associated fungal infection mucormycosis, as the state health department and collectors will control the supply with district-wise allocation and distribution to hospitals based on demand for treatment of mucormycosis.
Rough estimates by government hospitals and a few private hospitals show that Maharashtra has 1,500 mucormycosis patients of which 850 are hospitalised. But this may be an underestimation with several private doctors not reporting patients.
Based on the fungal spread, each patient requires 90-120 injections of amphotericin B for treatment stretching up to 15 days. The state’s daily requirement is 10,000 injections and fortnightly requirement is at least 1.50 lakh.
The supply is massively short as the state received 8,500 injections while Mumbai’s BMC received 1,000 injections in the past eight days, according to Food and Drug Administration (FDA) data.
“The procurement and distribution will be handled by the health department. They will supply to hospitals. Our role will be to monitor the manufacture and distribution chain,” said Parimal Singh, FDA commissioner.
National Health Mission commissioner R Ramaswamy issued a notification to all district collectors to monitor stock with chemists, hospitals and take control of supply of future stock based on patient prescription and demand raised by hospitals. In private hospitals facing acute shortage, stock will be diverted from civil hospitals, a government notification said. The distribution channel is similar to anti-viral Remdesivir, which faced acute shortage between March and early May.
Senior state officials said stock supplied to chemists will be monitored to curb black marketing and supply to them will be slowly reduced. “Chemists may actually find it hard to buy the stock as the central government is allocating quota to state government hospitals,” a health official said.
Major suppliers of amphotericin B are Cipla, Bharat Serum, Mylan and BDR Pharmaceuticals. The government is giving permission to new manufacturers to increase the supply.
In Satara, collector Shekhar Singh said they have begun hospital-wise allocation of the drug. “We have asked all general practitioners, physicians and hospitals to notify mucormycosis patients based on new rules to notify the infection. Based on this, distribution will be done. There is not enough stock so we will distribute some injections to all patients on a daily basis,” he said.
Patients undergoing home treatment may face difficulty in accessing the drug as demand will be generated by hospitals. Officials said they can approach the collector office or their doctors can issue requirement to health department to buy injection.
Singh said they are ready to supply stock from civil hospitals to private hospitals where patients are admitted.
So far, the fungal infection, associated with Covid-19 infection, has killed 90 people across Maharashtra with Nagpur repoting the maximum number of cases.
An FDA official said Haffkine Bio Pharmaceuticals in Parel has tied up with Kamla Lifesciences to procure the drug on a loan basis. The Maharashtra FDA held a meeting with BDR Pharmaceuticals, Bharat Serum and Kamla Lifesciences to discuss ways of increasing production.
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