Industry steps up to cure black marketing of Covid drugs

Some firms are now considering starting their own distribution centres in major cities

Rohit Kumar ’s ( name changed) elder brother, admitted in the ICU of a private Delhi hospital for Covid complications, was critical and needed tocilizumab. However, all hell broke loose when the hospital ran out of doses and asked him to arrange for the same.

“I made 60 calls from 9.00am to 11.00pm to get a pack of tocilizumab, which contained 4 pre-filled syringes. The MRP was ~45,000, but I ended up paying ~54,000, which was the best deal I got,” he said, adding that one of the vendors had put a price tag of ~92,000.

Agents and distributors have been selling drugs such as tocilizumab and remdesivir in the black market. In some cases, prices surge to six-fold that of the market price. Remdesivir is sold under the brands Cipremi by Cipla and Covifor by Hetero. While Cipla has priced the injectable drug at ~4,000 a vial, Hetero has priced it at ~5,400.

Following complaints of prices skyrocketing up to 7x, the government sprang into action.

Besides holding a meeting with manufacturers asking them to ramp up supply, the Department of Pharmaceuticals (DOP) wrote to the chief secretary to check these malpractices.

In fact, government sources said Cipla was trying to import a higher quantity of tocilizumab to meet demand. Tocilizumab, sold under the brand Actemra, is a Roche drug currently made in the US and Japan. It is marketed by Cipla in India.

Pharma majors, too, are taking guard against such malpractices. Both Cipla and Hetero have helplines through which they share information on availability and prices.

A Cipla spokesperson said the firm was working closely with regulatory authorities to restrict supply to hospital channels. According to regulatory guidelines, a state-wise list of such hospitals is available on the Cipla website.

Its helpline is not only for remdesivir but also for other drugs used in treatment of Covid-19. In a recent tweet, the firm noted that it has witnessed an unprecedented demand for remdesivir and tocilizumab. It

said it has ramped up supply and expects the demand-supply situation to normalise.

A spokesperson for Hetero, too, indicated that the company has started sharing updates on its website for Hetero Healthcare — its marketing and distribution arm. “This has details of the number of batches dispatched as well as what the upcoming supply of vials. It also has details of the helpline and the email in

which hospitals, patients, and distributors can connect,” the spokesperson said.

Being on the offensive against black marketing, Mylan — yet to launch its remdesivir brand in India — is putting in place a system prior to the launch, to curb black-marketing. Rakesh Bamzai, president (India and emerging markets) of Mylan, said they were putting in place strict measures to ensure patients in need have access.

Biocon, which has received the regulator ’s nod to market its Itolizumab brand, has said the drug will be sold through a closed channel to ensure zero black marketing.

“This will be a patient-specific drug, where we need to have the patient’s consent and prescriber ’s signature. If we find any instance of black marketing, we will take strong action,” said Kiran Mazumdar-shaw, executive chairperson of Biocon.

Developed and launched by Biocon in 2013 under the brand name Alzumab to treat moderate-to-severe plaque psoriasis, the drug has been priced at ~8,000 per vial.

Drugs like remdesivir are not sold through the over-the-counter mode. They are used on hospitalised patients, and hence sold through the hospital trade.

Some firms are now considering starting their own distribution centres in major cities, through which they could guide patients with valid documents. Patients may produce valid prescriptions, Covid-positive reports, and Aadhaar cards.

“It seems to be a nexus of doctors, hospital pharmacies, and distributors that is leading to this profiteering,” said a senior government official.

He added that government agencies had started cracking down on such complaints. The Drug Controller General of India or DCGI, chairperson of the National Pharmaceutical Pricing Authority (NPPA), and officials from the DOP met recently to discuss the issue.

Jagannath Shinde, chairman, All Indian Origin Chemists & Distributors, said he has requested firms and the government to allow distribution through some reputed chemists. “Right now, there is a lot of panic among patients once a doctor prescribes it. He runs from pillar to post, to source the drug quickly,” said Shinde, also a Cipla stockist.

Public hospitals in Mumbai said they have sufficient stock as the government has supplied the same to them. Avinash Supe, former dean of KEM Hospital, said remdesivir should be given to moderately sick patients showing symptoms of breathlessness.

“Close to 20 per cent of patients need it. If India has 300,000 active cases and only 10 per cent are given remdesivir, it would mean 30,000 patients (or 180,000 vials). The supply isn’t yet that much,” he said.

Private hospitals, too, point to the demand-supply mismatch. “A steady supply chain is available. But, 100 per cent of the demand is not being met yet,” said Sandeep Guduru, facility director at Hiranandani Hospital, Vashi.