“The government must be cautious about oral antivirals”

As India moves closer to possible approval of oral antiviral drugs like Merck’s molnupiravir to treat Covid-19, health experts want the government to proceed with caution on its supply and pricing.

Signaling the concern of drug resistance, if there is unhindered use, experts suggest more controlled distribution and storage of these drugs by government authorities.

Two oral antiviral drugs to treat Covid – molnupiravir from Merck and paxlovid from Pfizer – are in various stages of regulatory approval across the world. And while the British regulator gave the green light to molnupiravir earlier this month, the European regulator gave a favorable opinion on the drug on Friday, allowing member countries to obtain it, at a time when the region is experiencing a increase in cases.

Both drugs are due for review by the United States Food and Drug Administration (FDA), while molnupiravir is also under review by the Drug Controller General of India (DGCI).

“Affordability is not a big deal for people living in a place like Gurgaon and those who can apply for insurance and medical reimbursement. The problem will be for those who go to public hospitals and community health centers for treatment, ”said Virender Yadav, chief medical officer of Gurgaon. Activity area.

He added that more research was needed to determine whether people with comorbidities could receive the drug. Yadav also suggested that the drugs be supplied in a controlled manner by authorized distributors. Another antiviral, remdesivir, had seen prices skyrocket and became scarce in Wave 2, before the government streamlined matters.

Praveen Gupta, Director (Neurology), Fortis Memorial Research pointed out that since these drugs need to be given in the early stage of infection and maybe not everyone is willing to spend that much money. Storage may not be cost effective, he added, as these are expensive drugs and could be valued at between $ 10 and $ 20 per person. Reports suggest the drug is valued at $ 700 per patient (over 51,000), worldwide.

However, Vikramjeet Singh, senior consultant, internal medicine, Aakash Healthcare Super Specialty Hospital, said these drugs will be supplied to low- and middle-income countries through deals that would reduce the cost. Merck has pacts with about eight Indian pharmaceutical companies on molnupiravir, for local supplies at reduced prices.

Antiviral drugs needed?

Viswesvaran Balasubramanian, Interventional Respiratory and Sleep Medicine Consultant, Yashoda Hospitals, Hyderabad, said molnupiravir was the first oral antiviral that has been shown to be very effective when given to high-risk non-pregnant patients. There was a reduction in the risk of hospitalization or death of about 48%, he said.

“Although the government is moving at a very high pace to vaccinate as many people as possible as soon as possible, we need these pills because the Covid infections are still there. These drugs are a very, very promising remedy for the treatment of Covid. So obviously these drugs are needed, ”added Vikramjeet Singh, Aakash Healthcare.

Side effects

Gupta de Fortis said there could be side effects like fever, chills, difficulty breathing, nausea and headache.

“The usual side effects can be fever or allergic rash. There may be rare cases of liver problem in some patients,” Singh said.


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