Covid-19 medicine in Bangladesh only two weeks away

The antiviral drug, Remdesivir, to treat Covid-19 patients will be available in the domestic market within only two weeks.

Eskayef and Beximco, two of the eight approved companies, may start its supply by May 20, said Ruhul Amin, director of the country's drug administration.

Eskayef has already completed the production of the drug and is ready to provide samples to the national drugs administration.

After Remdesivir got an emergency use authorisation in the United States, Bangladesh too approved its production in the country.

Ruhul Amin said the US has found some effectiveness of Remdesivir in the treatment of the coronavirus. Applying this medicine will reduce the patient's stay in hospital to 11 days from 15 days.

The other six approved local companies to produce Remdesivir are Incepta, Beacon, Square, Acme, Popular, and Healthcare Pharmaceuticals.

Ruhul Amin said the antiviral medicine will be used in hospitals dedicated to Covid-19 patients.

Asked at what stage the drug would be given to patients, he said it has been applied to critical patients in the US and their experts probably have not changed the treatment pattern yet. "Our experts will decide when it will be applied to our patients."

Companies' preparations

Although eight companies have been approved for the production of the drug in Bangladesh, not all of them have completed their preparations yet.

Only three companies expect to market it this month. Of them, Eskayef and Incepta Pharmaceuticals said their drugs could be given to the drugs administration within two weeks.

Simeen Hossain, managing director and chief executive officer of Eskayef, said they started working on the drug from mid-March.

"We have already finished all procedures and are prepared to submit it to the drug administration," she said, adding that their medicine would be named as "Remevir".

Incepta Managing Director Abdul Muktari said, "Our research team is now working to find the effective step of the drug. There are some variables that have to be prepared by going through different processes.

"It usually takes a long time. The final stage can be reached after testing it at every stage. But I think we can give the product in two weeks."

Beximco's Chief Operating Officer Rabbur Reza confirmed their production would be completed within this month.

"However, when our study is over, we will understand exactly how much medicine will be needed for a patient," he said.

Giving an idea of their drug's initial price, the Beximco official said one vial might cost Tk5,000-6,000. A Covid-19 patient may need 5-11 vials of Remdesivir.

Meanwhile, Acme said they could still take at least two months to market the medicine.

Mizanur Rahman Sinha, managing director of Acme Laboratories said, "We have just got the permission. A decision has been made to import raw materials from India.

"We have to open a letter of credit and make a sample of the medicine after importing raw materials. If the drug administration approves it, we will begin final production."

The entire process is time-consuming, he added.

Ebaydul Karim, managing director of Beacon Pharmaceuticals, echoed him.

He said they have taken an initiative to import raw materials. As the drug is risky, it should be left for 14 days before the clinical trial even after production.

"As a result, after completing all the preparations, we can deliver the medicine to the people by the end of June," he said.

Where will Remdesivir be available?

Ruhul Amin, the drug administration's top official, said, "We have promised to give this medicine to the government hospitals first during the authorisation because most government hospitals are dedicated to Covid-19 treatment."

And if it is given to private hospitals, there will be some conditions. Because the amount of medicine is not surplus yet.

It will be based on hospitals only. It will not be available in drug stores, he added.

Ruhul Amin said that, so far, there has been no talk about whether there will be a trial of Remdesivir in Bangladesh.

Depending on the patient's treatment pattern, doctors will decide if the medicine will be applied for five days or 10 days, he added.

Unnecessary use should be stopped

Professor Sayedur Rahman, chairman at Pharmacology department in Banganbandhu Sheikh Mujib Medical University, said that the US FDA has given an emergency use authorisation to Remdesivir, meaning it can be used in four categories on an emergency basis.

It has been mentioned as a compassionate use only for hospitalised patients who are seriously ill, whose oxygen concentration is below 94 and who need a ventilator, he said.

He further said, "The difficulty in Bangladesh is that this medicine may be given to others instead of those who really need it.

"Even if the patient dies due to this medicine, the cause of death will not be known. Because there is no post-mortem anywhere for dead Covid-19 patients."

So, the government should issue clear instructions about it under the supervision of specialised doctors as well as the conditions stated in the US, Sayedur opined.

He said that once the drug is on the market, the risk of its misuse would be alarmingly high if it is found in drug stores. It can be used in patients at the upazila level if there is a specialist doctor and the patient is hospitalised and needs it.

Professor Sayedur, also chairman of Bangladesh Pharmacology Society, said an unnecessary use of this drug will put people at two types of risk: Financial and physical damage.

The abuse can be stopped if the government procures it in bulks and gives to designated hospitals. But it cannot be sold in the market, he remarked.