After Fabi Flu, Covifor and Cipremi enter Indian market to tackle COVID-19

With COVID-19 infections rising steadily in India—now the fourth-worst-hit country in the world—local pharmaceutical companies have swung into action to introduce generic (and therefore cheaper) versions of drugs that can help in keeping the infection rate and fatalities down.

Last week, Glenmark Pharmaceuticals launched FabiFlu—FabiFlu is made with the salt used in favipiravir, an antiviral drug that was originally used to treat influenza in Japan and other countries. Now, more pharma companies have come forward with their take on other drugs that have been effective in trials—the 2019 coronavirus infection does not have a cure as yet; remdesivir and favipiravir help in faster recovery in moderately ill patients who are on oxygen support and better outcome in mild to moderate illness, respectively.

According to the World Health Organization (WHO), there isn't a specific medicine that has been approved or recommended to prevent or treat the COVID-19 infection, which is caused by the coronavirus called SARS-CoV-2. Scientists and researchers have been working day and night to develop a definitive drug as well as vaccines to treat the disease that has already infected nearly 9.5 million people and killed nearly half a million of them (as of 25 June 2020).

Hetero Healthcare, an Indian pharmaceutical company, has now launched Covifor which is derived from the salts used to make remdesivir, for a retail price of Rs 5,400 per vial in the country. Covifor is one of two versions of remdesivir that have been launched in the country after Hetero and Cipla entered into licensing agreements with Gilead Sciences to manufacture the medicine in India.

According to Hetero, "We are prepared for ensuring enough stocks required to cater to the present needs. We will continue to work closely with the government and medical community to make a difference in the fight against COVID-19."

Remdesivir enters India via two new drugs
Remdesivir’s efficacy in treating COVID-19

Doctors for After Fabi Flu, Covifor and Cipremi enter Indian market to tackle COVID-19

Remdesivir enters India via two new drugs

Remdesivir is an antiviral drug that stops the virus from multiplying inside the body, by inhibiting an enzyme called RNA polymerase. It was originally developed to treat Ebola virus disease by US-based Gilead Sciences. Though the medicine did not work against Ebola, clinical trials have shown that remdesivir has some success in treating COVID-19 patients.

It also happens to be the only medicine that the US FDA (US Food and Drug Administration) has approved for emergency use to treat adults and children who have been hospitalised or have been confirmed to have COVID-19 from laboratory tests.

Along with Hetero, Indian pharma giant Cipla had also acquired the licence to produce remdesivir in India, and launched Cipremi in the Indian market at a price similar to that of Hetero's Covifor, in the region of Rs 5,000 per vial. Cipla’s Cipremi, however, has entered the market with a caveat that it must be given only to patients who are on oxygen support. (Read more: What is oxygen therapy?)

Both Hetero and Cipla were able to launch their drugs after getting approval from the Drugs Controller General of India (DCGI). Besides these two companies, two more pharma companies based out of India—Jubilant Life Sciences and Mylan—are also working on the production of remdesivir in the country.

"As part of a risk management plan, Cipla will provide training on the use of the drug, informed patient consent documents, conduct post-marketing surveillance as well as conduct a Phase IV clinical trial on Indian patients," an official statement from Cipla said.

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Remdesivir’s efficacy in treating COVID-19

Remdesivir proved to be effective in several studies on patients who were being treated for COVID-19 in hospitals around the world, but had not been put on a ventilator yet. It received approval to be used conservatively on patients after a paper published in The New England Journal of Medicine showed the medicine reduces recovery time from 15 to 11 days in COVID-19 patients.

That study included a sample of over 1,000 patients from countries such as the US, Denmark, Greece, UK, Germany, and more, and its findings suggested that the reduced recovery time for patients means the healthcare systems could be able to adjust to the rising rate of patients coming in.

However, due to the side effects of remdesivir, it isn't recommended to treat people with comorbidities such as renal impairment (kidney problems), or women who are pregnant or lactating. It wasn't advised to be administered to children under the age of 12 either.

Supportive care for patients in various countries have had different methods for treating them, including convalescent plasma therapy using blood plasma from people who were infected but have recovered from the disease, use of monoclonal antibodies, or even repurposing existing drugs for COVID-19—these medicines already exist in the market as they are approved for the treatment of other infections and diseases.