US hospital orders soar for Covid-19 steroid treatment

US hospitals have dramatically increased their purchases of dexamethasone in the last week after the cheap generic steroid was found to significantly cut the likelihood of Covid-19 patients dying. 

Hospitals hiked their orders for the drug by 610 per cent, according to Vizient, a healthcare services company that works with half of US hospitals. Suppliers were unable to keep up with demand, only filling 54 per cent of the orders, the company said.

Dan Kistner, group senior vice-president, at Vizient, said before last week, US hospitals had not been treating Covid-19 patients with the drug, which is usually prescribed for skin disease, arthritis, and bowel disorders, and almost all orders were being filled.

“In a day, demand went from less than 100,000 to 1m vials or tablets,” he said.

Orders for dexamethasone soared after a University of Oxford study released this month found the drug reduced deaths by one-third in Covid-19 patients who were on ventilators. Dexamethasone was hailed as a game-changer, because of its significant impact on the most seriously ill patients, and because with its patents expired, it is cheap and accessible. 

Anthony Fauci, the top adviser on the White House’s coronavirus task force, said after the results were published that a panel would rapidly review whether to recommend the drug for Covid-19 patients. But while it has not yet been issued with an emergency use authorisation for Covid-19 specifically, doctors are allowed to prescribe it for whatever they want. 

Mr Kistner said he wanted to “sound the alarm” that there needs to be more resiliency in the system so manufacturers can meet sudden demand. So far, he said, he is “cautiously optimistic” that drugmakers are working on increasing production and there will not be significant issues with obtaining more of the necessary active pharmaceutical ingredients. 

Pharmaceutical companies moved quickly to ramp up manufacturing of dexamethasone. In the week the study was published, India-based Cipla, one of the world’s largest generic drugmakers, said it would immediately restore production of the tablet form, and EMS, a Brazilian producer said it had ordered more raw materials to increase production. 

During large Covid-19 outbreaks in places like New York in March and April, US hospitals suffered serious shortages of drugs including those required for patients on ventilators, inhalers such as albuterol, and hydroxychloroquine, an antimalarial that some were using to treat Covid-19. 

Mr Kistner said he is monitoring over 60 drugs at risk of shortage and working with hospitals that are experiencing rising patient numbers in hotspots, such as in the south and the west of the US, to help them predict their needs.