New COVID-19 Drugs: Game changers Or Money Making Hoax

Are Favipiravir and Remidesivir really Game changer drugs?

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COVID 19 outbreak has been no less than the roller coaster ride of emotions bubbling inside the like boiling milk changing the consisting in no less than a seconds. We all have been gone through the cycle of fear, reassurance, more fear, denial, avoidance, acceptance, excitement, Furore, and disappointment.

The COVID progression doesn’t want to halt yet. Amidst of this, we have been relying on hope for the discovery of cures and whenever we hear a new drug name associated with the COVID we jump into excitement.

New COVID-19 Drugs are out!

The hot topic for gossip around the street corners has been the news of the discovery of two drugs being effective against COVID. Recently Favipiravir and Remdesivir got approval by the government in early June for the treatment of novel coronavirus disease. However, reality being that these two drugs have been availed in the pharmaceutical market since 2014 and aren’t as close to the word “discovery”

Favipiravir was developed by the Fujifilm group of Japan to treat novel influenza i.e severe cases of flu and Remdesivir was originally developed for battling hepatitis C but it went ahead and has been proved to be effective against Ebola virus, Marburg virus and now Coronavirus.

As the news of govt. approval came, every Indian pharma company joined to rat race of developing these two. Glenmark became the first company to get approval for making antiviral favipiravir tablets using their APIs (Active pharmaceutical ingredients) and announced on June 22 that drug will be available as a prescription-based medication for INR 103/tablet, with recommended dose being 1800 mg twice daily on day 1, followed by 800 mg twice daily up to day 14.

While Hetero Pharmaceuticals announced for the supply of drug Covifor (Remdesivir) intravenous injection vial at 5,400 per bottle. The patient will be given an intravenous injection of 200 mg on the first day and then 100 mg IV 5 days a day. 

This drug should not be prescribed to pregnant or nursing mums and minors under 12 years old. The Ministry of Health documents stated that patients should also not have liver disease and kidney complications.

Cipla also got the authorization for Remdesivir and dr reddy announced their official tie-up with Fujifilm for selling and marketing exclusively the brand Avigan (Favipiravir). Cipla announced Cipremi (Remdesivir) for COVID-19 drug under Rs 5,000

While medical experts have cautioned against seeing these potential drugs as a ‘magic bullet’ against the deadly virus, they can help reduce the viral load as India continues to post new record highs in infections daily.

All the above still doesn’t understand our question. Are these game-changers? Will the pandemic finally end and we get our normal lives back soon? What will be the impact of these rat race on the economy? Let’s find out this together!!

What the Kerfuffle is all about!

Yes! Favipiravir and Remidesivir are new players in the market for treating coronavirus but they are tested effective against only mild to moderate cases that too for patients who are not on oxygen supply. The trials against severe cases gave no good results.

One should know the clinical difference between all three.

Mild cases– Patients with no history of complicated respiratory tract infections or disease wherein only symptoms of COVID include sore throat, fever, fatigue, etc.

Moderate cases– Patients with symptoms like not so severe pneumonia, feeling mild breathlessness while walking or moderate exercise, headache, dry mouth etc. oxygen support is a precautionary measure for monitoring the progression of the disease.

Severe cases– Patients showing symptoms of extreme breathlessness as in difficulty in speaking, pain in the chest, higher temperature, etc. these are usually patients with complicated history of respiratory tract like asthma, chest blockage, Seasonal allergies. Severe cases require oxygen support during the entire process of treatment.

What happens in Moderate cases?

Once the process of breathing starts becoming difficult, that marks the onset of hypoxia. The virus starts infecting the lining of air sacs, the body starts releasing the chemicals to inhibit it. All of this happening in the narrow space causing the lining to thicken even more making it difficult for oxygen to pass dropping the levels and breathing rate. Thus these cases need to be monitored closely and oxygen support is often given to the patient.

Let’s whip some maths up!

FabiFlu tablets which are 103/tablet will come in 200mg. the recommended dose is 1800 mg twice daily on day 1, followed by 800 mg twice daily up to day 14 which loosely is 

Day 1- Nine tablets – Cost: 9×103= ₹ 927

Day 2 to 14 – Four tablets – Cost- 4x13x103= ₹ 5356

Total- ₹ 6283/-

While Covifor (Remdesivir) intravenous injection vial at 5,400 per bottle for 100mg vial. The patient will be given an intravenous injection of 200 mg on the first day and then 100 mg IV 5 days a day.

Day 1- two injections- Cost: 2×5400= ₹ 10800

Day 2 to 5- one injection a day- cost: 4×5400= ₹ 21600

Total – ₹ 32800/-

Important things to keep in mind:

  • This is the cost of treating the mild to moderate cases which as we know of are in bulk.
  • These two drugs are “no guaranteed cure” as these will only help in reducing the virus’s attack and not killing it entirely.
  • As Glenmark quoted Favipiravir shows clinical improvements of up to 88% in COVID-19, with a rapid reduction in viral load by 4 days. But there hardly is any evidence stating the details of the study conducted which points to even a major issue- the lack of transparency
  • Covifor can’t be administrated on your own. Covifor is under restricted use authorization in India. This means patients would need a doctor’s prescription to get it and that doctors will have to fill out a patient’s consent form before giving them the drug.
  • The union health ministry’s document on ‘Clinical Management Protocols for COVID-19’ stated that it is not recommended for those with severe renal impairment and high level of liver enzymes, pregnant and lactating women, and those below 12 years.

With traces of Favipiravir drug having been found in sperm and breast milk, FabiFlu (brand name of Favipiravir) must be used with great caution for COVID-19 treatment.

Patients must also be advised not to have intercourse with pregnant women till seven days after treatment. “The drug is contraindicated in pregnant and lactating women, and is not to be given to them,” according to a company spokesperson

  • Last month, the US National Institutes of Allergies and Infectious Diseases had released preliminary trial results showing recovery time of Covid-19 patients given Remdesivir improved from 15 to 11 days.
  • Questioning how these drugs are approved for COVID-19 treatment, the All India Drug Action Network (AIDAN) has written a letter to the Drugs Controller General (India), stating that lack of transparency in approving these drugs is akin to withholding important information about their use.

This approval comes at a time when cases in India are spiraling like never before, putting tremendous pressure on our healthcare system. We hope the availability of an effective treatment such as FabiFlu® will considerably help assuage this pressure, and offer patients in India a much needed and timely therapy option.

Mr. Glenn Saldanha, Chairman and Managing Director of Glenmark Pharmaceuticals Ltd

Please keep the things in mind and think in contrast to the above statement. Yes! There is pressure on the healthcare system. But the pressure is on common man too. I’ll let the readers decide would it be worth it spending all the bucks for the non- fatal cases that have the potential of healing itself over time. And even in Some cases say, yes it is worth spending 30,000 to save lives! Who is going to pay for the people with severe cases residing in slum? When we all know it, the families below the poverty line who contributes to most cases active today. 

Kudos to people who think it indeed is revolutionizing.

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