ISLAMABAD: As life-saving drugs black market is thriving with hundreds of novel coronavirus patients on ventilators and thousands of others facing breathing difficulties, the federal government on Saturday took notice of the unavailability and overpricing of the medicines being prescribed to Covid-19 patients.

Special Assistant to the Prime Minister on Health Dr Zafar Mirza announced that Tocilizumab [Actemra] and Remdesivir injections used for management of Covid-19 patients would be made available by the government, warning the black marketeers that overpricing would not be tolerated.

Meanwhile, former prime minister Yousaf Raza Gillani and star cricketer Shahid Khan Afridi also fell victim to the novel coronavirus, as the country reported 6,682 Covid-19 cases and 101 deaths during the past 24 hours, taking the national tally to 135,864 and fatalities to 2,596.

Railways Minister Sheikh Rashid Ahmed, who had tested positive for Covid-19 a few days back, was admitted to a hospital on Saturday night after his health condition deteriorated. Later, his condition was stated to be stable.

PM’s aide warns black marketeers that overpricing won’t be tolerated

Dr Mirza said overcharging on the approved prices of life-saving injection would not be allowed. Approved Maximum Retail Price (MRP) for Actemra (Tocilizumab) 80mg injection is Rs11,952 per vial whereas Rs29,882 for Actemra 200mg injection vial and Rs59,764 for Actemra 400mg injection vial.

Strict action would be taken against elements involved in the sale of overpriced or in the black marketing of life-saving drugs in accordance with DRAP Act 2012, the PM’s aide announced.

He said people would be encouraged to inform the Drug Regulatory Authority of Pakistan (DRAP) on its Toll-Free number 0800-03727 in case they had been overcharged for Actemra Injection. Directions had also been issued to the National Task Force on Eradication of Spurious and Substandard drugs to apprehend black marketeers and overcharging elements on approved prices of Tocilizumab Injection, he explained.

According to a DRAP statement, Tocilizumab injection is a humanized monoclonal antibody that ordinarily used as an immunosuppressant agent in rheumatoid arthritis. The national clinical management guidelines have included it for use in treatment of critically ill patients of Covid-19 who have Cytokine Release Storm (a condition that a subset of critically ill Covid-19 patients can develop and is established through certain laboratory tests). However, its availability remained an issue as it was being imported from Japan only. In order to resolve shortage, DRAP approved import of Tocilizumab injection from the US as well.

Although multiple consignments of the injection have arrived, it would be made available through the authorized distributor only. Hospitals and institutions treating critically ill Covid-19 patients can contact Roche company at phone number 0304-1111085 to check availability of this injection.

For the past few days, the company office has been telling callers that the injection is not available. However, the injection is being sold for Rs400,000 in the market.

DRAP stated that another important medicine, Remdesivir, is a relatively new antiviral medicine recommended for use in moderate to severe disease by Pakistan’s National Clinical Management Guidelines and has been shown to shorten the duration of illness.

In the Drug Registration Board meeting held earlier this week, two importers and 12 local manufacturers of Remdesivir have been approved for market authorization. The approvals would allow larger quantities to be made available. After the approval of medicines for emergency registration, the drug pricing committee of DRAP on Saturday held an emergency meeting on Dr Mirza’s request to fix maximum price for Remedesvir, a statutory requirement in accordance with Drug Pricing Policy 2018 and will be soon approved by the federal government. Information regarding Remdesivir registration status can be obtained from DRAP’s toll free number.

The Government of Pakistan is also planning to import and provide these life-saving medicines for the patients who cannot afford these medicines as “we consider this the State’s responsibility”, the PM’s aide said.

“To remove any confusion, it is important to clarify that until now importers were bringing very limited number of Remdesivir vials on individual patient-needs base which is a special arrangement under drug law. But after the recent approvals now importers will be able to import relatively large quantities which will enable us to overcome any shortages,” he added.

419 patients on ventilators

The National Command and Operation Center (NCOC) on Covid-19 on Saturday claimed that 29,850 tests were conducted in a single day making the highest count since the outbreak of virus in the country. So far, 839,019 Covid-19 tests have been conducted since Feb 26, 2020.

The NCOC claimed that in Punjab 233 patients were on ventilators, while there were a total of 387 ventilators, 9,276 beds, including 3,500 beds with oxygen.

In Sindh, there are 8,274 beds, including 739 beds with oxygen. The total number of ventilators are 368 and 83 of them are occupied.

In Khyber Pakhtunkhwa, 4856 beds are allocated for Covid-19 patients and 1,081 of them are with oxygen. Besides, there are 340 ventilators and 85 of them are engaged.

In Balochistan, all 36 ventilators are available. Of 2,148 beds, 262 have the facility of oxygen.

In Islamabad, 18 of the total 90 ventilators are occupied, while 262 of the total 514 beds for Covid-19 patients have the facility of oxygen.

Mohammad Asghar in Rawalpindi also contributed to this report

Published in Dawn, June 14th, 2020