Pune: District gets 5,192 remdesivir vials; no tocilizumab supply

PUNE: The district received 5,192 vials of remdesivir on Friday, but not a single vial of tocilizumab could be made available for the severely ill Covid patients, officials of the Food and Drug Administration said.
There has been no respite from the severe shortage of these key Covid drugs in the Pune Metropolitan Region (PMR) for more than a month now.While remdesivir, an anti-viral drug, is primarily meant for moderately ill patients, tocilizumab -- an imported drug -- is given to severely ill Covid patients.
“We distributed 5,192 vials of remdesivir among the hospitals treating Covid patients in the PMR. But we did not receive a single vial of tocilizumab for distribution on Friday,” said Shyam Pratapwar, assistant commissioner (drugs), FDA, Pune.
A total of 87 vials of tocilizumab were distributed among 27 hospitals on priority on Thursday.
Tocilizumab’s manufacturer, Roche, had stated late in July last year that during trials, the drug had failed to improve the condition of severely ill patients hospitalised with Covid-19 pneumonia. But doctors in Pune have continued to use the expensive drug.
Specialists and infectious disease experts from the city claimed that the drug had been effective in carefully selected patients. “It’s not totally useless,” senior physician Atul Joshi had said in an earlier interview.
“Tocilizumab can do the trick if used judiciously in the right subset of patients, and before there has been irreversible damage. In fact, it’s one of the most useful drugs in a certain group of critical patients with Covid-19,” he said.
Doctors from the Pune wing of the Indian Medical Association and the Association of Physicians of India also said subcutaneous administration of tocilizumab continued to be “effective”.
The specialists added that tociluzimab, if given to the right patients at the right time, had shown improvement in clinical conditions. In some cases, they said, X-rays revealed perceptible improvement. The drug tocilizumab, doctors said, yielded good clinical outcomes in patients with early-stage hypoxia (absence of enough oxygen).
Infectious diseases expert Parikshit Prayag, said, “Tocilizumab needs to be used early during hypoxia, not when lung damage has progressed to an irreversible stage. When patients have advanced respiratory failure and are on mechanical ventilation, it means lung damage is substantial. At that point, tocilizumab may not make a difference.”
Unlike remdesivir, produced by over seven pharma companies in India, tocilizumab is an imported drug.
Cipla Pharmaceuticals is the only Indian company to have an import licence.
The drug is very costly (Rs50,000 per vial) and its supply has remained erratic for over a year now.