In the wake of limited supply of tocilizumab injections, the Gujarat government has formed a high level committee of physicians to examine reports of critically ill COVID-19 patients who were prescribed tocilizumab injection to ensure its judicious use.
“A committee comprising specialists - Dr Samir Gami, Dr Alpesh Parmar and Dr Deepak Shukla has been formed by the state government to help examine reports of COVID-19 patients prescribed tocilizumab injection to ensure its judicious use. Patients should be continuously under observation if administered tocilizumab and should be given injection based on the weight and medical condition of the patient as per ICMR guidelines and treatment protocols,” explained Gujarat FDCA Commissioner Dr H G Koshia.
Available in dosage of 80 mg per vial, 200 mg per vial and 400 mg, tocilizumab injection is being used on COVID-19 patients who suffer from extreme immune system response towards the infection, called cytokine storm, leading to multi organ failure and eventually death.
Tocilizumab manufactured by Roche Pharma and marketed by Mumbai-based Cipla is sold under the brand name Actemra in India. Ever since Indian Council of Medical Research (ICMR) had gave guidelines for its off label use in June 13, 2020, it has been widely prescribed for critically ill COVID-19 patients.
Based on its novel use, two COVID -19 patients in the age group of 40 to 45 years at Gandhinagar Civil Hospital recovered successfully for the first time in Gujarat on May 2, 2020.
“A tocilizumab injection usually costs Rs. 40, 545 for 400 mg vial but Gujarat government prescribed it free of cost to urgently deal with COVID-19 pandemic,” Dr Koshia further added.
Tocilizumab in certain trial studies has shown to slow down the cytokine response in COVID-19 patients by modulating a protein called IL6. Union health ministry has separately approved a few hospitals in India to start multi-centre trial of this drug for critical patients of COVID-19.
National Pharmaceutical Pricing Authority (NPPA) had earlier directed Mumbai-based pharmaceutical major Cipla Ltd to supply tocilizumab injections to Gujarat.
Gujarat Medical Services Corporation Ltd (GMSCL) received 2,850 tocilizumab injections during last two months for treatment of COVID-19 patients in government hospitals. The directive was based on the recommendations of Gujarat Chief Minister Vijay Rupani and Gujarat FDCA Commissioner Dr H G Koshia to address the demand for injections in government hospitals for treatment of COVID-19 patients.
“Of the total 2,850 tocilizumab injections, batch of 1,400 injections were distributed in government and corporation hospitals and the rest 50% in private hospitals,” informed Dr Koshia.
Injection is also available in 162 mg prefilled syringe. Drug tocilizumab injection is a monoclonal antibody primarily meant for autoimmune diseases such as rheumatoid arthritis (RA). Clinical trials on tocilizumab are being done across the world. It has shown promising results in COVID-19 treatment based on its novel use.