Remdesivir, Favipiravir antiviral drugs 'no game changers' in COVID fight, say medical experts

With pharmaceutical companies launching generic versions of Remdesivir and Favipiravir for COVID-19 treatment, medical experts on Monday said it was a "positive development" in the fight against the pandemic, but cautioned against regarding the antiviral drugs as "game changers".

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Glenmark Pharmaceuticals has launched the antiviral drug Favipiravir, under the brand name FabiFlu, for the treatment of mild to moderate COVID-19 cases, while Cipla and Hetero have received approvals from the Drug Controller General of India (DCGI) to launch Remdesivir under the brand names Cipremi and Covifor respectively.

Cipla Ltd on Sunday announced the launch of Cipremi.

Dr Sanjay Rai, Professor at the Centre for Community Medicine, AIIMS Delhi, said till date no effective treatment or vaccine to combat coronavirus has been found.

"Till date we don't have evidence that a particular drug is effective, so we cannot call any drug game changer till then. With their launch, it will only be clear in the future how effective they will be. Whether they can play a supportive role in COVID-19 treatment is also not yet known," he told PTI.

Dr Vikas Maurya, Director, Department of Pulmonology and Sleep Disorders, Fortis Hospital, Shalimar Bagh, said drugs like Remdesivir and Favipiravir were "no game changers" as they were used for other diseases and have now been found useful in some way in treating COVID-19 patients.

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"It is not as if all those taking these drugs will recover," he told PTI.

It has been found that they help reduce viral load but are not game changers, Maurya said.

"But yes, it is a positive development as it is better to have something in hand than nothing. There is also a psychological impact that something is being given which could have some benefit," he said.

Dr Rommel Tickoo, Associate Director, Internal Medicine, Max Healthcare, also echoed Maurya's views.

Whatever studies that have been done on these drugs are very limited so they cannot be called "game changers", but their launch is a positive development as it is better to have something than nothing, he said.

"On both the drugs we have limited data, whatever evidence we have is mostly anecdotal. There is no specific treatment that we have and we cannot wait for all the trials to be over as many lives will be lost. So that is why emergency restricted use is being approved," he told PTI.

"It is difficult for us to categorically state the efficacy of the drugs, they do have the potential, but we need more data," he said.

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Noted city-based lung surgeon Dr Arvind Kumar said he does not believe that any of these antiviral drugs like Remdisiver or Favipiravir will be game-changers.

"If at all 'game changer' can be used, it is for dexamethasone which has shown a significant reduction in mortality and is available cheaply," said Kumar, who works at the Sir Ganga Ram Hospital here.

Dr Avi Kumar, Consultant, Pulmonologist, Fortis Escort Heart Institute, said drugs such as Favipiravir and Remdisiver "cannot be called game changers" as they are used as a supportive treatment.

"When given early, they can benefit patients but there is no guarantee that the patient will improve or not," he said.

"It is definitely a positive development that we will be using antivirals, but it is not a game changer as that term can be used for something which you give and the patient recovers," Kumar told PTI.

Drug firm Hetero had on Sunday said it has received approval from regulator DCGI to launch investigational antiviral drug Remdesivir for the treatment of COVID-19.

The drug will be available in 100 mg vials (injectable) which has to be administered intravenously in a hospital setting under the supervision of a healthcare practitioner, it said.

Asked about the price of the drug, Hetero Group of Companies MD Vamsi Krishna Bandi told PTI it will be in the range of Rs 5,000-6,000 per dose.

The drug has been granted approval by DCGI for the treatment of suspected or laboratory-confirmed cases of COVID-19 in adults and children, hospitalised with severe symptoms of the disease, the company said.

Cipla has also said that it has been granted regulatory approval by the DCGI for restricted emergency use in the country as part of the accelerated approval process considering the urgent and unmet medical need.

Commenting on the launch, Cipla Ltd MD and Global CEO Umang Vohra said, "Cipla appreciates the strong partnership with Gilead to bring Remdesivir to patients in India. We have been deeply invested in exploring all possible avenues to save millions of lives impacted by COVID-19 pandemic, and this launch is a significant milestone in that direction".

In May, domestic pharma firms Hetero, Cipla and Jubilant Life Sciences had entered into non-exclusive licensing agreements with drug major Gilead Sciences Inc for manufacturing and distribution of Remdesivir.

Glenmark Pharmaceuticals last week said it has launched antiviral drug Favipiravir, under the brand name FabiFlu, for the treatment of patients with mild to moderate COVID-19 at a price of about Rs 103 per tablet.

FabiFlu is the first oral Favipiravir-approved medication in India for the treatment of COVID-19, it said in a statement.