People have thrown all caution to the wind, jostling in large crowds to procure the drug while politicians have been accused of hoarding it, but the jury seems to be still out on the efficacy of remdesivir in curing Covid-19, so much so that experts have suggested that it may be dropped as well from India’s Covid treatment protocol.
An expensive drug that was also directed against Ebola
Created by the US-based Gilead Sciences, remdesivir has seen its demand shoot up ever since the US first drafted it as an emergency treatment for Covid-19 last year. It belongs to the category of antiviral drugs and was designed to counter diseases caused by RNA viruses, which includes the likes of the novel coronavirus. It was initially intended as a treatment for Hepatitis C but was then repurposed to counter the Ebola virus. However, when the Covid-19 pandemic broke, its makers saw the scope it could have as medication for the disease.
In the US, the full course can cost upwards of $3,000 (upwards of INR 2 lakh), depending on insurance cover. But amid the second wave surge of cases in India, domestic drug manufacturers slashed the price for 100mg vials of the injection by anywhere between Rs 1,000 to about Rs 3,000. While the treatment course is of six vials in the US, updated guidelines for its use issued by the Centre last year said that the dosage should be of 200mg on Day 1 followed by 100 mg doses daily for 4 more days for a total of a five-day course.
Last month, the government had also said that efforts were underway to boost domestic capacity to close to 80 lakh vials per month from a little under 40 lakh.
Why is there controversy over it?
While health officials have cited its efficacy in blocking the novel coronavirus, multiple clinical trials have suggested that it has next to no impact on curing the infection. Remdesivir has received emergency nod in India and, per health ministry guidelines, can only be administered within 10 days of onset of symptoms to patients displaying moderate to severe disease who need oxygen
support. Further, it is not recommended for people with liver or kidney dysfunction or for patients who are recovering at home and are not on oxygen support.
However, in November last year, WHO had in a “conditional recommendation” advised against the use of remdesivir in hospitalised patients “regardless of disease severity”. It had noted that there was “no evidence that remdesivir improves survival and other outcomes”.
Ganga Ram Hospital Chairperson Dr DS Rana told news agency ANI that “there is no such evidence regarding Remdesivir that it works in Covid-19 treatment. Medicines that do not have any activity to work, will have to be discontinued.” Coming on the heels of the government’s decision to drop plasma therapy as a recommended line of treatment, this statement has further fuelled the controversy around remdesivir.
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