BENGALURU: While the supply of Remdesivir has been regulated by the state government, the city is currently facing a shortage of Tocilizumab, one of the many drugs used for treatment of Covid-19 patients. It is manufactured by Swiss firm Roche Pharmaceuticals.Dr R Ravindra, Medical Director of Suguna Hospital and president of Private Hospitals and Nursing Homes Association, said, “There is a shortage of Tocilizumab. Off-label use of this drug has been approved but there is no constant supply. The price is around Rs 40,000 per vial and generally one to two vials are given to Covid-19 patients.”
Doctors resort to this drug when the patients have moderate to severe levels of corona infection and are not responding to Remdesivir and other drugs.NGOs, attempting to sponsor medicines for poor patients, are sourcing Tocilizumab from corporate hospitals that have more stock and giving it to smaller private hospitals and nursing homes where the needy patients are being treated“Pharmacies in smaller hospitals in the city cannot afford this drug as it costs Rs 40,545 per vial.
They ask us to approach representatives of the Cipla company. At times, the company does not respond and other times, they direct us to purchase from corporate hospitals that have comparatively more stock,” said Sabeel Nazir, trustee of NGO Naasih Foundation.“We sponsor genuine ICU cases, with proper documentation,” Nazir said.Dr C Nagaraj, Director of Rajiv Gandhi Institute Of Chest and Diseases, said they have not used this drug till now as the government did not supply it. It was only on Sunday that they received 18 doses from the state government.
“We will use it depending on the patient’s condition as the supply seems to be low. Tocilizumab is generally used where patients’ Interleukin 6 (IL-6) is high. IL-6 (group of proteins) is produced in response to infections, tissue injuries and contributes to host defence,” Dr Nagaraj said.Apart from this, owing to lack of sufficient data supporting its efficacy, some medicos have withdrawn use of Tocilizumab.
“Around 5-10% of patients with progressive disease tip into cytokine storm during the second week of their illness. Tocilizumab, an anti-inflammatory medication against IL-6, has been attempted to tide over this storm,” said Dr Sunil Kumar, Consultant, Interventional Pulmonology, Aster CMI Hospital.“In the initial days of this pandemic, it had a limited supply. Also, major adverse effects like reactivation of tuberculosis and predisposition to other infections posed a challenge,” he said.