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Irregular supply hits treatment: BMC-run hospitals ask patients to procure expensive Tocilizumab drug on their own

A Food and Drug Administration (FDA) staffer’s family and FDA officials recently had to run pillar to post to purchase 400 mg of Tocilizumab after the Nair hospital said they have run out of stock. The staffer, however, died the day the drug was administered.

Written by Tabassum Barnagarwala | Mumbai | Published: June 18, 2020 3:36:01 am
“The doctor said he requires Tocilizumab urgently for treatment, but the hospital had no stock. He asked us to arrange it. Since Rajkumar was critical we had little choice in the matter,” a FDA official said.

Irregular supply of the expensive Tocilizumab drug, an immunosuppressant used in the treatment of severely ill Covid-19 patients, has forced the Brihanmumbai Municipal Corporation (BMC) hospitals to ask several patients to procure the medicine for their own treatment in the last few days.

The BMC, which procures Tocilizumab from pharmaceutical company Cipla, each dosage costing between Rs 30,000-40,000, has been treating Covid-19 patients with their own supplies of the drug free-of-cost. With a spike in the number of Covid-19 patients, the civic-run hospitals, however, have been reporting problems with the supply of the drug.

A Food and Drug Administration (FDA) staffer’s family and FDA officials recently had to run pillar to post to purchase 400 mg of Tocilizumab after the Nair hospital said they have run out of stock. The staffer, however, died the day the drug was administered.

Rajkumar Sonavane (46), a Worli resident, was on deputation at medical education minister Rajendra Shingne’s office. After he developed fever and cough earlier this month, he was admitted to Poddar hospital. He was shifted to Nair hospital after his condition deteriorated.

“The doctor said he requires Tocilizumab urgently for treatment, but the hospital had no stock. He asked us to arrange it. Since Rajkumar was critical we had little choice in the matter,” a FDA official said.

The family of Sonvane, who worked as a clerk, borrowed money from relatives and started reaching out to suppliers. On June 15, they finally purchased a single dose of 400 mg of the drug from Eskay Pharmaceuticals for Rs 31,000. It was administered to Sonavane on the same day. “But by then his condition had become bad. Even the drug could not improve his health,” the FDA official said. Sonavane died at 10.30 pm Monday night after being breathless for several days, he suffered acute respiratory distress.

On Wednesday, state Health Minister Rajesh Tope said he is going to urge the Centre to provide supply of Tocilizumab and Remdesivir, two anti-viral drugs, to handle the huge patient load in Maharashtra. “We need these drugs to treat patients. We are going to urge the government to provide it on compassionate grounds. We need a huge stock of these two drugs immediately. Approvals from DCGI are pending for manufacturers. Till that happens, the drug must be made available to state,” Tope said.

Dr Mohan Joshi, dean in Nair hospital, said initial treatment with the drug “found 95 per cent patients were recovering”. Commonly used for rheumatoid arthritis treatment, Tocilizumab is being administered to Covid-19 patients with pneumonia and breathlessness and those at risk of cytokine storm to prevent further severity.

“Hundreds of patients have already been treated using this drug. We can’t have so much stock. The supply comes and goes. We are using it on patients when we have stock,” he said, adding the state government would refund the cost of procurement to Sonavane’s family. They, however, have not been refunded the amount as yet.

Currently, there were 1,024 patients admitted at Nair hospital and most require Tocilizumab, Joshi said.

Across India, a randomised control trial to see effects of this Tocilizumab has also begun at many places. Tocilizumab is manufactured by Roche Pharma, and marketed by Cipla. In India it is sold under brand name Actemra.

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