Stockpile eight essential Covid drugs; 12% more than what was consumed in second wave peak: Centre to Karnataka

The Centre has asked Karnataka to stockpile 12 per cent more drugs than that was consumed during the peak of the second Covid wave when the state saw more than 6.05 lakh cases. The state already has 37 per cent of the required stock of eight essential Covid drugs to meet the Centre's mandate.

The eight essential Covid drugs are Heparin, Intravenous Immunoglobulins (IV IG) for treating Covid complication Multi-System Inflammatory Syndrome in Children (MIS-C), Methylprednisolone, Dexamethasone, Remdesivir, Tocilizumab, Amphotericin B (used to treat black fungus), and Posaconazole.

To meet the Centre's additional 12 per cent mandate, the state has to procure three drugs in highest quantities: Amphotericin B, IV IG and Enoxaparin (Heparin) of which it has 3.26 per cent, 8.08 per cent and 13.12 per cent of the required stock respectively.

The state currently has stock sufficient for the first 30-45 days of the impending third Covid wave. But the state is stockpiling roughly three months worth of stock.

An official of Karnataka state Medical Supplies Corporation Limited (KSMSCL) requesting anonymity said, "Tenders for these drugs have been called for where 38 bidders participated. Price negotiation will be done today by asking bidders to match the lowest price at which drug procurement was done recently in Maharashtra, Telangana and Kerala."

On July 27, KSMSCL sent a proposal to the state government to procure these drugs asking it to allocate a budget. While the finance department gave an approval for the same, the cabinet approval is pending. "Once this comes through, orders will be placed," said the official quoted above.

Director of state-run Minto Eye Hospital, Dr Sujatha Rathod, told DH though plain Amphotericin B is being stockpiled, it cannot be used in Covid patients with diabetes or those with the slightest kidney problem.

"Liposomal Amphotericin B is definitely advisable for such patients. Others with no such problems can be given, provided intensified flushing out with saline is done after plain Amphotericin is given," she said.

Talking about the role of Heparin, Dr. Anoop Amarnath, member, state Critical Care Support Unit, said, "Covid is known to cause clots and Heparin is an anticoagulant. Low molecular weight Heparin (Enoxaparin) is given to all admitted Covid patients as a prophylactic (as a preventive measure) as well as a treatment dose. It is a part of the standard treatment protocol for Covid."

Paediatric Pulmonologist Dr Srikanta JT, member of state Paediatric Expert Committee, told DH, "IV IG is the only medicine known to not only prevent MIS-C side effects but also protect children from MIS-C. This is why IV IG is life-saving and should also be judiciously used. This is the reason the Centre is asking for stockpiling of this drug. If the third wave hits us in October, we could see a significant number of MIS-C cases in December."

Sl. No.	Name of the drug	Required	Stock on hand	(% of stock on hand)
1	Enoxaparin injection	23,19,931	3,04,322	13.12%
2	Methylprednisolone injection	1,40,095	1,36,696	97.57%
3	Dexamethasone injection	13,64,781	7,97,183	58.41%
4	Remdesivir injection	4,43,208	3,45,673	77.99%
5	Tocilizumab injection	5,611	3,642	64.9%
6	Amphotericin B deoxycholate injection	72,217	2,352	3.26%
7	Posaconazole injection	5,659	5,894	104.15%
8	Intravenous Immunoglobulins	3,712	300	8.08%
	Total	43,55,214	15,96,062	36.65%