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BMC to acquire 20,000 doses of Tocilizumab even as trials yet to determine efficacy



MUMBAI: The Municipal Corporation of Greater Mumbai is set to issue a tender for the procurement of 20,000 doses of the drug tocilizumab, as it hopes to address the high mortality rate in the city. Negotiations are on for procuring the 200 mg vial for Rs 15,000 per vial and 400 mg for Rs 30,000 per vial from Roche Pharma, the Swiss drug maker that manufactures the drug.

ET had earlier reported that tocilizumab was in short supply across the country as doctors had started off-label use of the drug. Tocilizumab, originally approved for rheumatoid arthritis patients, is being used for Covid-19 as it has been found beneficial among some patients in China. It has been found to block the multiplication of a protein called IL-6, which leads to a severe immune reaction called cytokine storm.

The health ministry has also recommended tocilizumab in its national clinical guidelines, which say the drug may be considered for patients with moderate disease and progressively increasing oxygen requirements and for mechanically ventilated patients who are not improving despite use of steroids.

“Use of these therapies is based on a limited available evidence. As the situation evolves, and when more data becomes available, the evidence will be accordingly incorporated, and recommendation upgraded. Further, use of these drugs is subjected to limited availability in the country as of now,” said the guidelines.

An official, however, told ET on condition of anonymity, “Several members of the state department were not too keen to purchase this drug as its effectiveness is still under question. They suggested using the money on providing oxygen or ICU enabled beds.”

The success of IL-6 drugs such as tocilizumab for Covid-19 suffered a blow this week after French drugmaker Sanofi and Regeneron of the US halted their clinical trials of another similar class of drug named sarilumab after finding it did not improve the conditions of severely ill Covid-19 patients.

Arvinder Soin, who is leading the tocilizumab trial in India, told ET earlier this week that it remains to be seen whether tocilizumab is different from sarilumab and how effective it is against the receptor, and whether the drugs work when the cytokine syndrome is not in advanced stage. However, he said, excessive use of drugs such as tocilizumab is coming in the way of completing clinical trials.


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