Why India does not have an edge in exports of azithromycin, the opposite Covid-19 ‘surprise drug’ 

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New Delhi:  The common-or-garden hydroxychloroquine (HCQ) has granted India an unlikely international strategic asset, as international locations world wide have begun stockpiling the drug to combat the coronavirus pandemic.  

However with some current research suggesting that the efficacy of HCQ in treating Covid-19 is enhanced by a dosage of azithromycin, there’s now set to be a rising clamour for the antibiotic primarily used to deal with bacterial infections.  

The demand for azithromycin, nonetheless, doesn’t give the Indian pharmaceutical trade any edge. For one, in contrast to HCQ, a number of international locations on this planet produce azithromycin.  

And in addition in contrast to HCQ, India isn’t self-sufficient within the manufacturing of azithromycin as New Delhi imports nearly all of its uncooked materials for the drug, referred to as energetic pharmaceutical elements (APIs), from China. 

Regardless of the challenges, the nation’s largest producer of Azithromycin, the Gujarat-based Alembic Prescription drugs, has began receiving orders from internationally, particularly the USA and Europe.

Different gamers together with Macleods Prescription drugs and Mankind Pharma stated the home demand has noticeably gone up. Macleods additionally stated that it has been receiving worldwide orders.

“We have now observed a rise in demand in a number of international locations the place we have now on-ground operations” stated Shailesh Pednekar, senior vice-president at Macleods Pharma. He, nonetheless, refused to reveal the names of the international locations. 

Azithromycin is an antibiotic used within the therapy of bacterial infections largely in and across the respiratory tract together with tonsils, throat, gentle tissues and lungs. Additionally it is used within the therapy of pneumonia and typhoid. 

It prevents the synthesis of important proteins required by micro organism to develop and therefore, prevents the an infection from spreading.


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Touted as doable treatment for Covid-19 together with HCQ 

A number of ongoing analysis seems to counsel a mixture of azithromycin and hydroxychloroquine  is efficient in treating Covid-19. 

As an illustration, scientists on the Rutgers Most cancers Institute of New Jersey are researching “if the mix of the 2, azithromycin mixed with hydroxychloroquine, is best for covid-19 than merely hydroxychloroquine alone.” 

And very similar to HCQ, azithromycin has gained prominence due to US President Donald Trump.  

On March 21, Trump had tweeted, “HYDROXYCHLOROQUINE & AZITHROMYCIN, taken collectively, have an actual likelihood to be one of many largest sport changers within the historical past of medication. The FDA has moved mountains – Thank You! Hopefully they may BOTH (H works higher with A, Worldwide Journal of Antimicrobial Brokers………be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE!”

A Croatian drug

Also called world’s greatest promoting antibiotic, azithromycin was found within the Seventies by a workforce of researchers at Pliva, a Croatian pharmaceutical firm.  

“From early trials, Azithromycin proved to be extraordinarily environment friendly and able to remaining within the physique tissue of animals longer than different related antibiotics,” in accordance to the World Mental Property Organisation (WIPO).  

In 1981, the corporate filed a patent software for azithromycin and patented it worldwide, together with in the USA. Nonetheless, in 1986, Pfizer underneath a licensing settlement acquired the proper to promote Azithromycin worldwide. “Pliva, nonetheless, maintained the proper to promote the product in Central and Japanese Europe and would earn royalties on Pfizer’s gross sales,” WIPO states. 

In 2008, Pliva grew to become a part of the Israel-based Teva Prescription drugs.  

At current, Pfizer sells the drug underneath the model identify Zithromax and Zitromax in additional than 30 international locations throughout the globe together with Malaysia, Italy, Belgium, Spain, Canada, Eire and Denmark.


Additionally learn: India is testing for Covid-19 antibodies, however unlikely to let recovered sufferers transfer freely


Standing of drug in India

Based on knowledge with the  analysis agency IQVIA, India offered 12 crore strips of the drug final 12 months, which is round 60 crore tablets (a median of 5 tablets a strip). The highest model right here is the Vadodara-based Alembic’s Azithral.  

It’s the largest participant within the azithromycin market, estimated Rs 550 crore a month. 

Alembic, which additionally claims to be the biggest participant in promoting energetic pharmaceutical elements (APIs) of azithromycin to the world, holds 30 per cent market share in promoting the completed tablets of the antibiotic in India.  

“Our three manufacturing vegetation for the azithromycin APIs produce 20 tonnes each month, which could be expanded to 40 tonnes. Typically, one crore tablets are manufactured utilizing 5 tonnes of API,” Rajkumar Kumar Baheti, Chief Monetary Officer, Alembic Prescription drugs, advised ThePrint.  

Alembic exports all of its APIs. For completed tablets, the corporate, going by the estimates, can manufacture round 10 crore tablets per thirty days.  

Based on the info given by trade to the well being ministry, Indian requirement is 75-80 metric tonnes of the drug, which is round 12-20 crore tablets month-to-month.  The opposite gamers available in the market embody Cipla, Mankind, Ipca Laboratories, Solar Pharma, Wockhardt and Micro labs amongst others.  

Gurgaon-based Mankind Pharma produces round 25 lakh tablets each month however doesn’t export. “We produce 2-3 crore tablets for the drug yearly utilizing 30-40 % capability of our plant,” R.C. Juneja, CEO of Mankind Pharma, stated. 


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Rising Demand 

Baheti from Alembic stated that the corporate is receiving orders from nearly all of its API purchasers from international international locations, which in flip promote formulations (completed medicines) to different nations. “Majority of orders are coming from the USA, particularly South America and Europe. However I don’t wish to reveal the main points of their places,” Baheti stated.    

“Of the full manufacturing, solely 5-12 tonnes is the home requirement. We’re, nonetheless, retaining buffer inventory with us as India’s necessities are the primary precedence and exports are secondary,” he stated. 

Dependence on Chinese language imports is a problem 

Not like HCQ, the place India is self-sufficient in manufacturing of the drug, for azithromycin, nearly all of firms import the APIs from China, particularly Wuhan, the preliminary epicentre of the coronavirus outbreak. 

Whereas Alembic leads within the manufacturing of APIs on this planet, as the corporate claims, it additionally imports the intermediates and key beginning materials from China and different elements of the world. “The one problem is the inputs for APIs come from China and different elements… Coordinating the provision chain is usually a activity at instances. Nonetheless, we have now sufficient buffer inventory,” Baheti stated. 

Juneja from Mankind added, “In anticipation of shortages (as a result of Covid-19 pandemic in China), we’re totally inventory as of now and there’s no scarcity. If the demand picks up, we can match it.”


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