COVID surge drives up demand, supply of drugs via illegal network

Distributors, pvt dealers part of supply chain; Tocilizumab, Remdesivir sold at 3 times the MRP

CHENNAI:

While the private hospitals express helplessness in arranging for drugs for patients due to lack of stock, dealers and private distributors are making money through the black market network. Most patients go through private hospitals and their doctors to procure the drugs, while doctors are aiding dealers and distributors with fake documents to hoard drugs for supply upon request.

The medical representatives in hospitals play a huge role in the illegal procurement of life-saving drugs that are in limited supply in the State.

While the doctors prescribe these drugs and assist medical representatives with identity proof, RT-PCR reports and prescription, the network of drug distributors and dealers is being roped in to sell these drugs for COVID patients at a much higher price available in government sector or it’s maximum retail price.

The highest demand appears to be for Tocilizumab, a drug distributed in limited quantities to different states by the Centre. As per sources with Tamil Nadu Drug Control Authorities, the State was allocated just 200 units of Tocilizumab recently. It is used to treat critically ill COVID patients and according to the Union Ministry of Health and Family Welfare protocol, Tocilizumab

can be used on patients with oxygen requirements, and in mechanically ventilated patients who are not improving despite use of steroids. An 86-year-old COVID patient’s family was asked to arrange for Tocilizumab after he developed inflammation. The patient’s family contacted the distributor of a major pharmaceutical company for Tocilizumab, and they were asked to contact a local dealer who could supply the drug for Rs 1,50,000. (Detailed report on Page 2)

The supply and distribution has gone in reverse gear, as dealers are now contacted directly by the patient’s family through contacts and known sources.

The dealers also help in procuring drugs if the patient’s family is not willing to share the medical documents or ID proof documents as the doctors arrange for documents in any other patient’s name who does not require the drug. Drug Controller K Sivabalan said surprise inspections are being done by making requests for the drugs with dealers and distributors also to catch hold of people involved in illegal procurement of drugs used for positive patients.

While police have started cracking down on the sale of drugs such as Remdesivir for a higher price in the black market, they have sought information from the public if they come across any such transfer of drugs. “The problem is that those who are in need of such drugs and are ready to pay extra for it will not come forward to tip police about the network. But we have set our informants and have been monitoring the movements. We will soon know if there is any major nexus involved in it. From the arrests we have made so far, it looks like there is no major network involved,” said a senior police official.

The official said that the people who really need these drugs may not be able to get them due to the presence of black market and it has to be stopped.

CHENNAI: Several drugs including Remdesivir, Tocilizumab, Dexamethasone and Itolizumab are seeing a huge demand among the COVID-19 patients, especially the ones requiring treatment for inflammation, low saturation levels and for treating cytokine release syndrome in patients. As the demand has surged in the past few months, these drugs are out of stock in most of the hospitals that are authorised to provide them to their patients. However, these drugs are being sold by dealers and distributors at a much higher price in the market.

Meanwhile, many dealers still cash upon selling Remdesivir at high costs as patients admitted in private hospitals require the drugs on an urgent basis. Rajkumar (name changed) was the only caretaker of his family of four who had tested positive for COVID-19, including his 73-year-old mother. As his mother turned serious upon admission at a private hospital, he was asked to obtain Remdesivir. Since he could not stand in the serpentine queue for obtaining the medicine and had a small time frame to obtain six vials for his mother, he asked doctors for help. The doctors put Rajkumar in touch with medical representatives in the hospital who directly take account of the medicine and drug stock in the hospital. The medical representatives promised to get the drugs within 24 hours but at a cost of Rs. 33,000 for six vials as he had to pool in medicine dealers for the procurement of the drugs. Rajkumar paid Rs. 33,000 for six vials of Remdesivir which costs around Rs. 9,360.

The Tamil Nadu Medical Services Corporation has recently opened two counters at Kilpauk Medical College and Hospital for the direct distribution of Remdesivir to COVID-19 patients who require the same after producing identity proof, RT-PCR reports and doctor’s prescription. However, drug dealers with the help of private practitioners are procuring the drug from the counters and selling it to the patients at a higher cost. The cost of one vial of Remdesivir at Kilpauk Medical College and Hospital is Rs. 1,560, but the single vial is being sold for Rs. 5,000 by the dealers.

While the hoarding of drugs continues through a chain of doctors, medical representatives, distributors and dealers, the State Drug Control Authorities say that action is being taken against these people in particular cases with the help of the police department.

“We are conducting investigations when we receive the complaints regarding the hoarding of drugs like Remdesivir and upon inspection, the arrests are being made. Tocilizumab is an imported drug and is supplied to private hospitals through government supply only via the distribution channel of Cipla pharmaceuticals. The drug is an off label drug, meant for the treatment of Rheumatoid arthritis. The black marketing of the drug can happen through medical representatives, distributors or dealer links with other States and local distributors linked in the particular sector,” said Drug Controller K Sivabalan.

We’re conducting investigations when we receive complaints regarding hoarding of Remdesivir and upon inspection, arrests are being made

K Sivabalan, Drug Controller