The outbreak of the coronavirus disease started in the city of Wuhan, China, in December 2019. Since then, it has spread horrendously throughout the world at a rapid speed, and many individuals have been affected by this viral disease. This pandemic is creating a problem for many drug manufacturing companies, including companies responsible for Amphotericin B production, as different countries have adopted different kinds of quarantine policies across the globe.
AMPHOTERICIN B and COVID-19
Amphotericin B is an anti-mycotic drug that is used to treat fungal infections. It is intravenously administered to treat potentially life-threatening fungal infections such as torulose, aspergillosis, systemic candidiasis, histoplasmosis, and mucormycosis.
Mucormycosis is a fungal disease that occurs when a person comes in contact with mucor. This disease affects the sinuses, lungs, and brain. It can be life-threatening in immune-compromised patients. People affected by mucormycosis are rising lately. Doctors believe that the steroids used to treat COVID-19 patients are triggering these cases of mucormycosis. Steroids help in reducing the inflammation of the lung of COVID patients, but on the others hand; it decreases the overall immunity of the body. This drop-in immunity can be triggering cases of mucormycosis.
Price Impact
India is considered as one of the global leaders when it comes to drug supply to other countries. It has already been forecasted that India’s API will reach revenue of USD 6.00 billion by the end of 2020. India exports 30 percent of the API’s used in the U.S, and also, the majority of API’s required by different companies across the world for the manufacture of generic drugs is supplied by India. But India imports almost 65 percent of its total bulk API requirements from China for the medicine formulations. During this pandemic period, as China’s competitiveness towards India is increasing, they are raising the cost of their API’s which would ultimately result in the disruption of the drug manufacturing market and would increase their prices.
As rising cases of Mucormycosis on COVID-19 patients are observed, the anti-fungal drug demand is also increased, which resulted in the price hike and black marketing of this life-saving amphotericin B drug.
For instance,
- Two persons have been caught in Chandigarh, Haryana, for black marketing amphotericin B drug. They were trying to sell one vial of amphotericin B for USD 164.83
Impact on Demand
Mucormycosis has close ties with COVID-19 as people affected by coronavirus are also affected by mucormycosis if proper hygienic conditions are not maintained as the world sees a new rise in the number of coronavirus-infected cases. It is expected that people getting affected by mucormycosis will surge. The demand for amphotericin B is going to increase as it is an effective treatment for mucormycosis.
Due to the lockdown regulations, many drug manufacturing companies have been suffering to deal with the market demand. The government has taken initiatives to deal with the rising demand for the drug.
For instance,
- The cabinet approved an investment of USD 13.94 Billion to increase APT production, out of which USD 4.2 billion was for mega parks and USD 9.4 Billion was the support of Industry domestic production efforts
- Almost 27 API’s were planned to be made through chemical synthesis, and 26 API’s were to be made through fermentation. API’s for drugs like ganciclovir and valganciclovir are also supposed to be manufactured
- The government of India has licensed 5 manufacturers to produce amphotericin B production due to the rise of mucormycosis cases
This shows that the initiative taken by the government is helping to tackle this COVID-19 situation as amphotericin B needed for the treatment for mucormycosis are now starting to get manufactured domestically and the situation is likely to get better in the future.
Impact on Supply Chain
COVID-19 has led to a disruption in the supply chain of drugs. Lockdown policies in different countries have resulted in pharmacies closing walk-in customers to prevent the spread of the disease. This leaded to increased demand for home delivery and mail delivery systems. This led to a significant delay in the supply of the drugs. Also, during the lockdown period, the market for online delivery of drugs has seen a rise, which is normal considering the situation.
As many pharmaceutical companies are dependent on China for the supply of API’s their recent price hike has disrupted the manufacturing process of the drugs. Due to this, many companies are looking to diversify their API gathering according to their geographic location. The demand for lipids used for the manufacture of amphotericin B has seen a sharp rise due to rising mucormycosis cases, but the supply of those lipids is not ample as the drug was rarely used previously.
The investment made by the government of India for domestic manufacturing of amphotericin B will make the future of mucormycosis treatment in India a lot better.
A complete ban on the import of different goods from other countries has completely disrupted the supply chain.
The leading companies of the amphotericin B market worldwide have taken strategic steps to properly supply their drugs to people across the world.
For instance,
- Sun Pharmaceutical Industries Ltd., a leading manufacturer of amphotericin B has maintained its drug supply across the world. They formed a licensing agreement with Eli Lilly for the manufacturing and distribution of barcitinib in India, which is used alongside remdesivir to treat coronavirus infected patients
- Cipla Inc., a leading manufacturer, has maintained its supply chain during the pandemic. They have included remdesivir, favipiravir in their manufacturing portfolio. They have also formed an agreement for the distribution of Roche’s Actemra
This shows that even if the COVID-19 situation is disrupting the supply chain of API’s and the manufacture of drugs, the government of India and different major companies is creating a hope for the proper supply of drugs.
STRATEGIC DECISIONS FOR MANUFACTURERS
COVID-19 can hamper the production of amphotericin B, but it also allows companies to improve their business by different means. As a pharmaceutical company always does, they tend to find newer and better ways to treat a disease; same is the case for mucormycosis. Always bringing better solutions in the market would increase their business efficiency.
For instance,
- VAV Lifesciences, a leading manufacturer of the lipids required for the manufacturing of amphotericin B is planning to increase their manufacturing capacity of lipids from 21kgs of lipid per month to 130kgs of lipid per month
- TLC, a clinical-stage specialist pharmaceutical company announced that CDSCO of India had approved the new drug application AmphoTLC (amphotericin B) to meet the shortages of liposomal amphotericin B
This signifies that despite this COVID-19 situation, different strategic decisions made by these companies would make their business grow.
Conclusion
As this pandemic situation has resulted in many restrictions around different places globally, the market leaders of amphotericin B market have been able to manage their drugs stock. The supply chain was destroyed as most of the drug manufacturing companies did not get their API’s for the proper drug formulation, but the government of India took several steps and as well as different companies which will help them to get their needed API’s and properly carry out the drug manufacturing process. New companies have been approved for the manufacturing of amphotericin B, and also new drug applications are getting accepted to meet the shortages of amphotericin B as the number of cases of mucormycosis is rising. By increasing the raw materials price, the companies can maintain their overall revenue. Thus different companies of this amphotericin B market find their ways to deal with this pandemic situation.
