Virus inhibitor remdesivir in the Netherlands is on, rules changed | Abroad

The European Commission purchased the drug centrally for the EU countries. According to the spokesperson, the Ministry of Health, Welfare and Sport has always turned to the committee in recent weeks, because the RIVM stock was rapidly shrinking due to the increasing use of the virus inhibitor. The number of corona patients has increased rapidly in recent weeks.

The hospitals themselves do not have a stock of remdesivir in house. They must order the drug from the RIVM if they need it. The spokesperson does not know how much remdesivir has been ordered in Brussels for the Netherlands. He points out that there is a shortage of the drug worldwide, because the demand is greater than the supply.

Remdesivir ‘not a panacea’

Experts say Remdesivir is not a panacea, but doctors do hope it will be available again soon. “If it is not available for a few days, then that is not a disaster, but this must of course be resolved quickly,” says lung specialist Leon van den Toorn of Erasmus MC. Due to high worldwide demand, the supply to the Netherlands has come to a standstill.

Remdesivir is frequently prescribed to corona patients in the Rotterdam university hospital, in combination with the drug dexamethasone. The latter is an anti-inflammatory that has been around for decades.

Research suggests that patients receiving dexamethasone survive their infection more often, spend less time in hospital, and require treatment in intensive care less often. The scientific evidence that remdesivir helps is somewhat less clear-cut. In one study, it was found to speed up the recovery of patients who needed supplemental oxygen, which is quickly the case in admitted people with Covid-19. The Working Group on Antibiotic Policy (SWAB), which draws up guidelines for doctors, cites it as a treatment option.

“It’s a slightly different thought,” says Van den Toorn. “Dexamethasone is really recommended, remdesivir has been said so far: you should seriously consider it for some of the patients,” said the pulmonologist, who is also chairman of the Dutch Association of Physicians for Pulmonary Diseases and Tuberculosis (NVALT). He estimates that it is prescribed in about 70 percent of Dutch hospitals.

Remdesivir has not been shown to benefit people who have mild complaints or who are in such bad shape that they can only breathe artificially through a device.

When remdesivir was approved in Europe at the end of June, chairman Ton de Boer of the Medicines Evaluation Board (MEB) wrote that it is “not a panacea”.

Annelies Verbon, the chairman of the Dutch Association of Internist-Infectiologists, calls the current shortage “difficult”, but she also said on Radio 1 that remdesivir is “not the big game changer”. “Every little bit helps, but there are other drugs that do more,” said Verbon, who also refers to dexamethasone.

Pulmonologist Van den Toorn says that with the current combination treatment, only about one in five corona patients admitted ends up in intensive care. “On the first wave it was about half.” Because the two drugs are given at the same time, it is not possible to say exactly how big the contribution of each individual drug is.

Remdesivir was actually developed against hepatitis C and was later used against Ebola, but the drug from manufacturer Gilead did not work well against those diseases.

Pharmacy rules amended

Hospital pharmacies are temporarily allowed to exchange remdesivir among themselves. The Healthcare and Youth Inspectorate (IGJ) is relaxing the rules due to the shortage.

Normally hospital pharmacies are not allowed to deal with each other in medicines. In this case, exchange is allowed, at least until December 31, because some hospitals still have sufficient remdesivir in stock, while in other hospitals shortages arise, according to the IGJ. The supply of the drug has come to a standstill, because worldwide demand is greater than supply.

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