Private hospitals in Silchar face a shortage of Remdesivir as Govt. earmarked doses can only be procured from Guwahati

Private Nursing homes in Silchar are facing a shortage of Remdesivir injections. Remdesivir is an antiviral injection approved by the Food and Drug Administration (FDA) for the treatment of COVID-19 in hospitalised adult and pediatric patients. There is a nationwide crisis of the drug and the Government has already waived customs duty on Remdesivir and its raw materials and components used to make the drug.

As informed by the Cachar district health department, currently there are 62 patients in Silchar Medical College and Hospital, 27 in Military Hospital, 19 in Civil Hospital, two patients in the facility at CRPF – Dayapur camp. While these government facilities have adequate stock of Remdesivir injections Green Heals Hospital which has 22 patients and Gracewell which has four patients admitted are facing a crisis.

On April 26, Health Minister Himanta Biswa Sarma had announced that the state has 25,000 doses of Remdesivir injections and out of them, 2,500 doses have been earmarked for the Private Nursing homes dealing with COVID patients. He said if a doctor prescribes Remdesivir to a patient, the attendants or the officials from the private hospital can collect doses from Guwahati Medical College and Hospital after producing the necessary prescription. He added a caveat that the private hospitals must provide the doses to patients at the government rate of Rs 1500 + GST.

“We have discussed the matter with the Silchar Medical College and Hospital authority and they have told us that there is no such directive to them which suggests sanctioning of doses to Private hospitals,” Rudra Narayan Gupta, Director, Green Heals Hospital

While for the private hospitals in Guwahati, it is easy to procure from GMCH during an emergency, the hospitals in Silchar don’t find this as a viable option. Director of Green Heals Hospital, Rudra Narayan Gupta said he has already placed an order on full payment for the stock of Remdesivir with the marketers of the drug, but it has not been delivered yet. Because of the nationwide crisis, the distributors are diverting supply where the need is maximum, and in such a scenario, the private hospitals will depend on government stock during emergencies.

“We will provide the medicine if required and certified by doctors,” Commissioner and Secretary, Department of Health, Samir K Sinha

“We have discussed the matter with the Silchar Medical College and Hospital authority and they have told us that there is no such directive to them which suggests sanctioning of doses to Private hospitals,” said Gupta. He added, “For the larger benefit of the general public in Barak Valley, it is essential to have a government facility in Silchar – be it the SMCH or district drug store, with the permission to sanction doses. In that case, we can send the patient’s attendant to get the drug as per requirement. We need the injection to treat patients.”

There is frustration among the attendants of patients too. Responding to Barak Bulletin’s query on private Hospital’s scarcity, Commissioner and Secretary, Department of Health, Samir K Sinha said, “We will provide the medicine if required and certified by doctors.”

According to the officials at the Department of Health, how private nursing homes can procure Remdesivir injection is something that National Health Mission – Assam is authorised to comment on.

“There is no regionalism here that we are providing to Guwahati and depriving, Silchar, Tezpur, Dibrugarh, or any other region in the State,” Dr. S Lakshmanan, Director NHM Assam

Speaking with Barak Bulletin, director NHM – Assam, Dr. S Lakshmanan said it is only for the better management of stock, “a simple central system” has been put in place and that is why the doses must be procured from Guwahati. “People think they need all five doses at one go and few feel all patients need Remdesivir. These are incorrect perceptions. Not all patients need Remdesivir. So, we need a doctor to prescribe the dose and then the doses can be procured from Guwahati,” said Lakshmanan.

It is a critical drug and Dr. Lakshmanan feels the management needs to be accurate or else the state might face a crisis. However, as stated by the private hospitals in Silchar and attendants of patients, in case of emergency, how can someone collect the dose from Guwahati? “We are working only to save lives,” said Lakshmanan. “There is no regionalism here that we are providing to Guwahati and depriving, Silchar, Tezpur, Dibrugarh, or any other region in the State. Please understand that Remdesivir doses have been made available at Medical Colleges and Hospitals to treat local patients,” added the director of NHM Assam who was earlier the Deputy Commissioner of Cachar.

If sources are to be believed then NHM is planning to develop a system where the first dose of Remdesivir for a patient in an emergency at a private facility can be procured from the nearest Medical College and Hospital. But the remaining four doses need to be procured from Guwahati. The NHM is vigilant against illegal marketing of the doses and that is why strict measures are in place.

A professor – related to Medical Sciences who wished not to be named, appreciated the measures of NHM. The professor urged the people of Barak Valley to not make it a Barak – Bramhaputra issue. “The government’s primary job is to ensure that enough doses are in stock at the government facilities. SMCH has adequate doses and there are still ample amount of beds available at the COVID ward. In such a scenario, it is fair that the doses are not made easily available to private hospitals. If a patient in an emergency at the private hospital is unable to procure Remdesivir injections from Guwahati, the simplest solution is to shift the patient to SMCH which has successfully treated thousands so far. It is important to trust the healthcare system instead of vehemently questioning it,” said the professor.

Adding, “Having said so, the role that private hospitals play during the pandemic is significant. If they are finding it difficult to procure Remdesivir injections, they can collectively approach the government and the NHM using its sources that can help them procure the drug. It is also an essential service and very much for the benefit of the general public.”

In Delhi and Mumbai, Remdesivir vials are illegally sold at Rs 20,000, Rs 25,000. Pandemic for some is an opportunity they cannot miss. Considering the repercussions, the NHM has decided to keep the system centralised in Guwahati. However, since the journey from Silchar to Guwahati involves travel via Meghalaya which has its own set of restrictions and regulations, can Silchar Medical College and Hospital be also trusted with the responsibility of handing over Remdesivir to private nursing homes only when needed? It remains to be seen how the private-public partnership flourishes in this case.