LAHORE: The Punjab government is faced with an acute shortage of the only life-saving injectable drug – Actemra – available for critical Covid patients, after the multinational company, the sole manufacturer world over, has expressed its inability to supply the medicine till December.

The three state-run teaching hospitals having Actemra, have been left with very limited stocks of the medicine that was earlier being provided to all the public and private sector hospitals across the province on a demand basis.

The situation has further compounded for the government as the number of the critical virus patients has increased manifold, as is evident from the official figures that show that nearly 74 percent of the beds at the intensive care units (ICUs) of the public hospitals of Lahore have been occupied, while the company postponed a consignment of 2,000 vials of the drug that was to arrive on Thursday (tomorrow) in the country. The percentage of the occupied beds for critical patients had dropped to only six before the beginning of the fourth spike of the coronavirus in the city.

Meanwhile, as per data released by health department on Tuesday, Punjab reported 1,839 new cases of the infection during the last 24 hours, while the virus claimed lives of 53 more patients during the same period, which was also the highest during the recent wave of the pandemic.

74pc of beds for critical patients in public hospitals occupied

An official privy to the information said the most worrying part of the situation was that the Punjab government had a very limited stock of Actemra, leaving the patients and their families at the mercy of black marketers.

He said though the drug was only being distributed officially, there were multiple complaints that some of the leading private hospitals of the city were charging many times higher than its official price (around Rs80,000 per vial).

The official said that sensing seriousness of the situation, the overnment has constituted a committee comprising three senior medics to recommend measures to overcome the impending crisis. The committee was also directed to prepare proposals to find an alternate drug that could be used to avoid Covid-related complications among the patients during the Actemra shortage in Punjab.

Headed by the King Edward Medical University (KEMU) Dean Prof Saqib Saeed, the committee comprised two leading medical experts -- senior pulmonologist Prof Javed Hayyat from the Pakistan Kidney and Liver Institute (PKLI), Lahore and Associate Prof Somia Iqtidar from Mayo Hospital, Lahore.

The official said the Punjab government had recently placed an order for 2,000 Actemra vials to the multinational company Roche, but it expressed its inability to ensure the supply due to the drug’s shortage in the international market.

In a letter written to the Punjab government on Aug 16, Ali Akbar Lone, the distribution manger of the company in Pakistan, said the global supply situation of Actemra (tocilizumab) had not improved yet. He said in order to ensure an equitable distribution across the world, the company was constantly evaluating the evolving situation, including Pakistan’s demand, and responding accordingly to ensure continuous supply.

Mr Akbar said all steps were being taken to increase the manufacturing capacity by ramping up production networks. “Roche Pakistan Limited is fully aware of the gravity of the situation and is making every effort to make this product available as soon as possible to cater to the urgent and increasing demand of the patients,” reads the letter.

Consultant for Covid in Punjab and KEMU former vice chancellor, Prof Dr Asad Aslam, said the drug’s shortage was discussed in a meeting of the Corona Experts Advisory Group (CEAG) on Monday last. He confirmed that Roche had officially conveyed to the Punjab government about suspension of the supply till December 2021.

“The Punjab government was alive to the patients’ worries as it has allocated sufficient budget for the procurement of Actemra,” he said.

Actemra actually helped reduce pain and swelling caused by rheumatoid arthritis, he added.

Published in Dawn, September 1st, 2021