TB patients denied new drug, says Mumbai doctor
THERE ARE MANY PATIENTS WHO DON’T HAVE ACCESS TO THE DRUG AS THE GOT HAS ROLLED IT OUT ON A TRIAL BASIS AT LIMITED CENTRES IN INDIA
national tuberculosis (TB) control programme is denying ‘desperate’ patients access to the new drug, bedaquiline, said a Mumbai doctor in an article in the latest edition of the international medical JournalThe Lancet.
Bedaquiline is the first anti-TB drug to be rolled out in the last 40 years and is a ray of hope for ‘extremely drug resistant’ cases of TB, which are immune to regular drugs and are very difficult to treat. Patients with such complications have high mortality rates.
Dr Zarir Udwadia, chest physician from PD Hinduja Hospital, Mahim, who routinely sees severely ‘drug resistant’ cases of TB, who wrote the article, said that “India’s National Tuberculosis Control Programme’s (RNTCP) insistence on reserving bedaquiline for patients who have at least three susceptible drugs in the background regimen, denies this drug to the very patients who would most benefit from it, especially since it doubles the chance of a cure.”
“It worries us that such patients, denied access to a lifeshe saving drug, are compelled to move the judiciary to access it,” he added, referring to the case of an 18-year old woman from Patna, whose father moved the Delhi high court in January, after was denied the drug at Lala Ram Sarup TB Hospital on the grounds that she was not a resident of Delhi.
While she was eventually given access to bedaquiline after the court ruled in her favour, there are many patients who don’t have access to the drug as the government has rolled out the drug on a trial basis at limited centres in India. “The woman’s case is emblematic of the desperation of the many patients with advanced drug resistance and with few therapeutic options that we encounter in our clinic,” wrote Dr Udwadia.
For many patients, doctors procure the drug from the pharmaceutical Janssen, the only firm that manufactures the drug, on ‘compassionate basis’, which is a tedious task, say doctors.
“The process of application is a tedious and onerous one, and includes an online application and review of each case by the company (Janssen), application for the import permit, dispatch, shipping, and customs clearance. The mean time from application for the drug to its receipt was 49 days. For three patients, the drug was interminably held up at Indian customs,” he wrote.