Bombay HC Directs Setting up Centralized Portal for Availability of Remdesivir, Tocilizumab

The HC bench comprising of Justices ZA Haq and Amit Borkar was listening to a suo-motu Public Interest Litigation (PIL) which was taken up during the onset of the Coronavirus pandemic last year.

Taking note of the issues regarding the unavailability of Remdesivir and Tocilizumab injections raised in the earlier hearing the HC bench in the recent order dated 13.04.2021 mentioned, "If a patient is not able to get the bed in a Dedicated Hospital and is not able to get service even in Outdoor Patient Department in Dedicated Hospital and such patient undergoes treatment in a Non-Dedicated Hospital and the Doctor treating such patient is of the opinion that the dose/doses of Remdesivir Injections is / are required to be administered to such patients, the Collector of the District shall ensure that the dose/doses of Remdesivir Injections is / are made available to such patient also."

The HC bench has also given some directions to ensure the availability of the Tocilizumab injections mentioning, "The details of availability of Tocilizumab Injections with the pharmacists shall be made available on the centralized portal which is being started by the Collector, Nagpur."

Also Read: Prices of Remdesivir slashed, now as cheap as Rs 899, says NPPA

During the previous hearing on 12.04.2021, the learned Amicus Curiae and learned Advocates appearing for petitioners and interveners mentioned that because of the paucity of beds in Government Hospitals and Dedicated Hospitals, needy patients were required to go to Non-Dedicated Hospitals and some serious patients required Remdesivir Injections and they were not getting those injections.

The Amicus Curiae and learned Advocates for the petitioners and interveners also submitted during the previous hearing that some persons were getting prescriptions in the name of one patient from different Doctors to purchase Remdesivir Injections and were selling the same in black-market.

They also raised the issue about the non-availability of Tocilizumab Injections. It had been also submitted that Tocilizumab Injections were being sold at the counters of private pharmacists at very high prices and there was reason to believe that some persons had hoarded these injections.

Also Read: India at a healthcare crisis : Hospitals run out of oxygen, beds, drugs and Mental strength

Replying to these concerns, the learned Senior Advocate Shri M.G. Bhangde submitted before the court on 13.04.2021 that on instructions from the Collector, Nagpur a centralized portal, containing the name of the patient with details/number of aadhar card of the patient, name of the hospital where such patient is hospitalized/treated and the number of dose/doses given to the patients will be started immediately and wide publicity about it would be given.

It has been further submitted on the behalf of the State that the hospitals where the patients are administered dose/doses of Remdesivir Injections will have to ensure that the required data is updated on the centralized portal immediately as soon as the dose/doses of Remdesivir Injections is/are administered to the patients.

The counsel for the State further submitted that if a patient is not able to get a bed in a Dedicated Hospital and is required to be administered dose/doses of Remdesivir Injections, he can be given the dose / doses in the Outdoor Patient Department of that Dedicated Hospital. In such cases also, the concerned hospital will have to update the details as stated earlier on the centralized portal immediately.

"If a patient is not able to get the bed in a Dedicated Hospital and is not able to get service even in Outdoor Patient Department in Dedicated Hospital and such patient undergoes treatment in a Non-Dedicated Hospital and the Doctor treating such patient is of the opinion that the dose/doses of Remdesivir Injections is/are required to be administered to such patients, the Collector of the District shall ensure that the dose/doses of Remdesivir Injections is/are made available to such patient also. Such patient shall not be denied the Remdesivir Injections only on the ground that he has undergone treatment in a Non-Dedicated Covid-19 Hospital. In such case also, the Doctor (having minimum MBBS Degree) of the Non-Dedicated Covid-19 Hospital who is treating the patient will have to certify in the prescribed format with all the necessary reports that such patient requires dose/doses of Remdesivir Injections. Further, in such case also, the details shall be uploaded on the centralized portal," mentioned the HC order.

Addressing the issue of the Tocilizumab injections, the counsel for the State submitted that Tocilizumab Injections are being imported by Cipla Pharmaceuticals and there is one Depot of Cipla Pharmaceuticals at Nagpur from where the medicines are distributed to pharmacists.

He further submitted that the injection is imported and the distribution and supply of these injections are not regulated by the State Government and its authorities, and the distribution and supply is regulated by the Central Government / Authorities.

As the ASGI Shri U.M. Aurangabadkar sought time regarding regulation of these injections by the Central Government / Authorities, the HC bench issued some directions regarding the matter.

The directions of the HC bench included,

"(a) The Joint Commissioner, Food and Drugs Administration, Nagpur shall take all the details from the Depot Manager or from the Authorized Person working at the Nagpur Depot of Cipla Pharmaceuticals about the receipt of Tocilizumab Injections.

(b) The Joint Commissioner, Food and Drugs Administration, Nagpur shall also collect the data from the pharmacists to whom Tocilizumab Injections are supplied from the Nagpur Depot of Cipla Pharmaceuticals or from the Agent of Cipla Pharmaceuticals.

(c) The Depot Manager / Responsible Officer of Nagpur Depot of Cipla Pharmaceuticals and the agent and pharmacists shall furnish all the details to the Joint Commissioner, Food and Drugs Administration, Nagpur within two hours of receipt of the notice from the office of the Joint Commissioner, Food and Drugs Administration, Nagpur regarding that. These details shall be collected in respect of transactions from 01/03/2021 onwards.

(d) The Agent of Cipla Pharmaceuticals at Nagpur and the pharmacists who are supplied Tocilizumab Injections and who have sold it shall also furnish the details to the Joint Commissioner, Food and Drugs Administration, Nagpur immediately. These details shall be collected in respect of transactions from 01/03/2021 onwards.

(e) If any of the above persons fail to give the necessary details, the Joint Commissioner, Food and Drugs Administration shall take strict action against the erring person.

(f) The details of availability of Tocilizumab Injections with the pharmacists shall be made available on the centralized portal which is being started by the Collector, Nagpur."

Apart from the issue of these two drugs, during the hearing on 13.04.2021, the counsel for the State government submitted the acceptance of the proposal regarding setting up of oxygen plant/factory at Nagpur. It has been further stated that the Government is considering setting up of such plants also at some other places in the State of Maharashtra, and for that purpose, the Chief Secretary, Government of Maharashtra has convened an official meeting on 15/04/2021.

Addressing the crisis regarding beds for Covid-19 patients, the HC bench further directed the Collector of Nagpur to examine whether beds can be made available for the needy patients at Mankapur Stadium, Nagpur and at Nagpur Nagrik Sahakari Rugnalaya. The Collector has been asked to submit a report regarding the matter within the next hearing.

Taking note of the submissions by the Amicus Curiae regarding the two hospitals under the control of Indian Railways, with infrastructure having oxygen supply and ventilators which are claimed to be under-utilized, the HC bench directed the ASGI to discuss the matter with the concerned railway authorities and ask them to interact with the Collector, Nagpur so that the facility which is not being properly utilized can be utilized to its optimum for the needy patients.

To view the HC order, click on the link below.