Centre issues advisory to stop Remdesivir's irrational use; only hospitals to procure drug

On Monday, the Health Ministry, AIIMS, and ICMR issued an advisory to stop the irrational use of anti-viral drug Remdesivir amid the second novel coronavirus wave. The Drugs Controller General of India had granted approval to Remdesivir for restricted emergency use in treating COVID-19 patients in a hospital setting on June 1, 2020. The latest advisory is premised on the findings of the 'Adaptive COVID-19 Treatment Trial' and the 'Solidarity Trial'. The former found that the anti-viral drug is useful only in moderate-severe cases if it is administered within 7-10 days.

On the other hand, the interim results of the WHO study which was conducted from March 2020 at 405 hospitals in 30 countries showed that it had little or no effect on hospitalized COVID-19 patients. In the wake of this, the Centre has reiterated that Remdesivir will be used only in select moderate/severe hospitalized COVID-19 patients on supplemental oxygen.

Moreover, doctors have been advised to exercise extreme caution in using this drug as it is potentially harmful, has relatively high cost, and limited availability.

Here are the recommendations to stop Remdesivir misuse:

• Remdesivir should be procured and provided by the hospitals only. The patient’s relatives should not be asked to procure it from the retail market

• Remdesivir must be advised by senior faculty members/ specialists directly involved in patient's care

• If Remdesivir has to be advised/ ordered during odd hours, it should be done by the duty doctor after telephonic consultation with a senior faculty member/ specialist/ unit in-charge

• Advise/ order for Remdesivir must be written and bear the name, signature, and stamp of the concerned doctor

• Every hospital needs to set up a Special Drug Committee which must review the use of Remdesivir in their hospital periodically. It would be preferable to have a Pharmacology Professor as a member of the SDC

• The SDC should share its findings with the clinicians periodically to ensure rational and judicious use of Remdesivir

COVID-19 situation in India

At present, there are 14,01,609 active novel coronavirus cases in India while 2,71,59,180 patients have been discharged and 3,49,186 deaths have been reported. While the country has shown a considerable dip in daily cases indicating that the second wave is on the wane, the vaccination drive was adversely affected since May 1 owing to a shortage of doses and the decentralized vaccine procurement policy. Addressing the nation on Monday, PM Modi rolled back this policy and announced that the Centre will procure 75% of the vaccine stock and distribute it to the states for free from June 21.

Most importantly, this stock can now be used for all adults and not just those aged above 45. With the Union government predicting that 216 crore vaccine doses are in the pipeline, the inoculation drive is expected to get a huge impetus. A total of 18,69,49,727 persons have been inoculated in India whereas 4,51,30,810 of them have received the second dose of the vaccine too.