Faced with shortage of drugs for black fungus, hospitals ration doses

The State government is grappling with a severe shortage of drugs to treat the fungal infection mucormycosis even as cases are on the rise. Doctors, too, have admitted to rationing doses.

On Friday, Karnataka State Medical Supplies Corporation Ltd. allotted 2,000 vials of Liposomal Amphotericin-B and 2,000 vials of Lipid Complex Amphotericin-B. But that is not enough to meet the daily demand. Multiple doctors told The Hindu that each patient requires five to seven vials of the drug a day. At five vials per person, the allotment is less than half the demand.

Preferred drug

Of the two drugs, Liposomal Amphotericin-B is the preferred one as the other drug is said to be nephrotoxic and cannot be administered to diabetics and senior citizens. “Most patients who are developing the fungal infection are diabetics and cannot be administered Lipid Complex Amphotericin-B. So the effective availability of the needed drug is much less than what is shown,” said a health official from a district neighbouring Bengaluru.

Though private hospitals have been allowed to procure the drug independently in the domestic market, they are unable to do so as most supplies have been taken by the government. The Union government has also barred its commercial import.

H.S. Prasanna, president of the Private Hospitals and Nursing Homes Association, said Liposomal Amphotericin-B is being “extremely rationed”. “No private hospital can guarantee patients the full dose of the drug for treatment. Some hospitals are also refusing admission,” he said. He added that some were trying to manage with a less effective alternative drug.

Turning to govt. hospitals

Patients with black fungus who have had surgeries at private hospitals are turning to government facilities seeking Liposomal Amphotericin-B. At present, there are 169 patients at Bowring Hospital and 177 at Victoria Hospital. Nearly half have had surgeries in private hospitals but sought hospitalisation in the government institutes in the hope that the drug would be available there. However, the drug is being rationed even there, said sources.

The government is pinning its hopes on additional allotment from the Centre. The Union Department of Chemicals and Fertilizers on Thursday said that while the domestic production of Liposomal Amphotericin-B had shot up to 3.76 lakh vials for June, 5.33 lakh imported vials had come to the country, which would be distributed across all the States.

The PHANA has demanded that the Centre allow them to commercially import the drug from abroad. “I have vendors from Germany, Dubai, and Singapore who are ready to supply the drug commercially. Either the government must import these supplies itself or allow us to do so. There is no room for red tape in a crisis like this,” Dr. Prasanna said.

Vinay Kumar, a patent consultant working with BMC-92, a group of volunteer doctors, said that they had had a similar experience recently. “We tried procuring the drug from a manufacturer in Germany, but were not allowed to do so. Eventually, our donors helped a firm in Amritsar procure raw materials from Singapore and after a three-week ordeal we have now procured 790 vials,” he said.

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Printable version | Jul 25, 2021 12:39:05 PM | https://www.thehindu.com/news/national/karnataka/faced-with-shortage-of-drugs-for-black-fungus-hospitals-ration-doses/article34854285.ece

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