With United States President Donald Trump bringing up antimalarial drug hydroxychloroquine, again, the spotlight will be on Indian drugmakers Ipca and Zydus Cadila, who are major producers of this drug used that’s to treat patients with the novel coronavirus.

Over the weekend, Trump said that he had requested Prime Minister Modi to release stocks of the drug the US had ordered. And to quote Trump, India was giving the request “serious consideration”.

For this transaction to go through, the pathway will evidently have to be cleared by the highest offices in the country. Because the export of hydroxychloroquine was banned not just late in March. But a note on Saturday (April 4) from the Directorate General of Foreign Trade said that the export of hydroxychloroquine was prohibited “without any exception”.

The weeks ahead will unravel how this transaction will go through, a move that will benefit companies like Ipca and Zydus. Late in March, Ipca has said that the United States Food and Drug Administration had made an exception to the existing “import alert” (bans) for the company’s Active Pharmaceutical Ingredients and finished products of hydroxychloroquine sulphate and chloroquine phosphate. Ipca and Zydus did not comment on the fresh demand on the drug.

Game changer?

Widespread interest involving this antimalarial medicine had been triggered by Trump, who called it a “game changer”, only to have experts step in and temper the optimism with caution.

Studies are ongoing to assess if the drug is indeed a “game changer” when taken alone or with antibiotic azithromycin. In fact, doctors advise against rampant use of the drug as a preventive, unless under medical supervision, due to its effect on the heart’s rhythm. Despite this, there was a run on the drug in India and other countries leading to a shortage of the medicine and in some instances, death. In fact, the Indian government, too, subsequently tightened its grip on the drug by ensuring it is sold only on a prescription and given only to healthcare workers and close contacts of people confirmed with the coronavirus.

Chloroquine and hydroxychloroquine are antimalarials, but the latter is also used in treating rheumatoid arthritis and lupus. According to market intelligence company AIOCD-AWACS, the estimated size of the hydroxychloroquine market was ₹152 crore for the 12 months upto February, and chloroquine was pegged at ₹51 crore. Ipca’s sales of hydroxychloroquine was close to ₹125 crore. Other makers of the product included Torrent Pharma, Alembic and Sun Pharma, among others.

Globally, Bayer, Teva, Novartis and Mylan are in the fray. And Bayer has already committed to making a 3-million donation of its Resochin (chloroquine phosphate) to the US. Interestingly, Bayer’s production facility in Pakistan supplied China during the outbreak.

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