Government tightens availability of remdesivir treatment for COVID-19 patients as supplies shrink

Owing to a rise in COVID-19 hospitalisations, the Department for Health and Social Care has enforced extra rules on remdesivir treatment to counter the “increased demand against available supply”.

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The supply disruption alert from the Department for Health and Social Care has asked that clinicians prescribe a maximum five-day course of remdesivir, instead of a treatment course of up to ten days as was previously advised

Patients with COVID-19 across the UK will now have to meet additional criteria before being prescribed remdesivir as supplies of the drug become limited.

The additional requirements will mean patients who are on mechanical ventilation or extracorporeal membrane oxygenation will not be considered for treatment with remdesivir.

The criteria were initially set out in guidance published on 3 September 2020, but were said to be “only applicable should demand for remdesivir exceed supply”.

The Department of Health and Social Care (DHSC) announced plans to enforce the extra rules in a supply disruption alert published on 29 September 2020.

It said clinicians should now adhere to the additional criteria as the treatment had seen “increased demand against available supply” in recent weeks.

The latest alert has also requested that clinicians prescribe “a maximum treatment course of five days”, which is half the maximum treatment length initially suggested when remdesivir was first approved for use against COVID-19 in July 2020.

However, a recent study suggested that there is no significant difference in efficacy between five-day and ten-day courses of the drug in patients with severe COVID-19.

The alert also asks trusts to share information on their stock of remdesivir with regional procurement pharmacy leads.

“A percentage of stock will be held centrally to support allocation to areas of greatest need, using the principles of mutual aid,” it says.

A spokesperson for the DHSC told The Pharmaceutical Journal that it is “aware of a rise in the use of remdesivir in line with a rise in COVID-19 hospital cases”.

“While supplies of remdesivir continue to increase, we have asked the NHS to temporarily prioritise patients to ensure those most likely to benefit can access it.

“Patients are also receiving other approved treatments; for example, dexamethasone or hydrocortisone, which have been proven to save lives and are in good supply.”

The DHSC added that it was expecting further supplies of remdesivir towards the end of October 2020 and it anticipated that the additional criteria will only be in place for a matter of weeks, subject to levels of hospitalisation.

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Citation
The Pharmaceutical Journal, September 2020;Online:DOI:10.1211/PJ.2020.20208410