Covid-19 impact: Hydroxychloroquine's share in pharma exports minuscule

Some health researchers have used hydroxychloroquine, along with a combination of a common antibiotic azithromycin, as a potential treatment for Covid-19.
India, the world’s largest producer of hydroxychloroquine (HCQ), exported $51 million worth of the drug in FY19. This was a minuscule portion of the country’s $19-billion pharma exports.

In FY20, however, exports had dipped to $36 million till February. With US President Donald Trump campaigning for HCQ, global demand for the inexpensive drug has surged all of a sudden. Countries like Brazil and India’s SAARC neighbours have sought the drug from India.

The Centre itself has requisitioned 100 million tablets from Ipca Laboratories and Cadila Healthcare. Manufacturers claim there is enough stock for the Indian market, and that the surplus could be exported. They are gearing up to supply the same to the government within this month.

Further, China does not make HCQ and India is the lead global supplier, they add.

HCQ and chloroquine phosphate are in the same class of drugs. Chloroquine is an anti-malarial used to prevent and treat malaria.

HCQ, on the other hand, is used to treat auto-immune disorders like rheumatoid arthritis, lupus, and as a third-line treatment for diabetes.

Some health researchers have used HCQ, along with a combination of a common antibiotic azithromycin, as a potential treatment for Covid-19. In a government advisory, India recommended the use of HCQ for healthcare workers and high-risk individuals to prevent contracting the infection.

The drug is also being administered to Covid-19 patients. Experts, however, have warned against wide use of the drug until the efficacy of it is proven beyond doubt, through clinical trials.

In a March 19 release, the US FDA had said that it was working closely with other government agencies and academic centres that were investigating the use of chloroquine, to determine whether it could be used for treatment.

Back home, sales of HCQ witnessed a spike. Data from market research firm AIOCD AWACS showed there was a 19 per cent jump in sales of HCQ in February. This is because many Indians were stocking up the drug that suddenly came into limelight, with the price at hardly Rs 3 per tablet.

However, the question now is, does India have enough stock?

Leading manufacturers that Business Standard spoke to claimed that there was no need to worry about supplies locally. India can roughly make 100 tonnes of the drug per month if required, as capacities can be easily scaled up.

Ipca is the drug’s top manufacturer globally, and the US FDA recently lifted import alerts on its plants, paving the way for the firm to export it to the US. Cadila was already exporting it to the US, though the numbers were not huge.

Cases have started doubling every four days now. From over 4,000 cases, the total number is expected to spike in April. “Each patient needs a 14-tablet course. With 100 million tablets, India can potentially treat 70 million people. Even if the number of cases spike to 100,000 within a month and each patient needs three healthcare workers, there would be enough stock in the country,” explained a manufacturer.

Cases of malaria and reported deaths have reduced in India over the years — the malarial death rate declined to 0.02 per 100,000 people in 2018, from 0.1 deaths per 100,000 people in 2001. “We make the active pharmaceutical ingredient (API) for the drug here, and are one of the largest suppliers of the API globally. Most European countries and the US do not make this drug, given malaria is not a major killer in these countries,” said one manufacturer.


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