ABOUT THE PROVISION OF DRUGS "REMDESIVIR" AND "TOCILIZUMAB" (ACTEMRA) FOR COVID-19

The list of medicines included in the protocol of diagnosis and treatment of CVI is approved by the Ministry of Healthcare of RK. The Joint Commission on the Quality of Medical Services (JCQ) of MHRK develops recommendations for improving clinical protocols and medicine provision.

The developers of the protocol are leading infectious diseases specialists, pulmonologists and other clinical specialists of RK, who are constantly in search of innovative and effective medicines.

In the process of gaining experience and the emergence of research in the treatment of this life-threatening infection, the clinical protocol was periodically revised. The protocols provide and include methods of diagnosis, treatment and rehabilitation, depending on the seriousness of the disease, at the outpatient, inpatient levels and intensive therapy in intensive care units, as well as rehabilitation measures at each of these levels of medical care.

Provision of the drug "Remdisivir"

The drug Remdesivir was included in the Clinical Protocol for the Diagnosis and Treatment of coronavirus infection COVID-19 in adults on April 1, 2021. At the inpatient level, Remdesivir is prescribed on the recommendation of a medical council when signing an informed consent in patients when the potential benefit exceeds the potential risk. At a later stage of the disease, it is possible to prescribe the drug by the decision of a medical consultation, depending on the clinical situation.

The drug Remdesivir is not included in the List of the Single distributor for 2021, approved by the order of MHRK No. KR DSM-90/2020 dated July 28, 2020.

On the basis of the order of the Ministry of Healthcare of RK, on July 30, 2021, the Single distributor purchased 124,707 vials of the drug Remdesivir.

18,500 vials of the drug arrived in Kazakhstan. After passing the customs clearance procedures, safety and quality assessment, the medicine is promptly shipped to all regions to ensure the medical organization of the country.

Shipment to the warehouses of the Single distributor began on August 14, to the regions/medical organizations from August 16, 2021.

The next batches of the drug in the amount of 21,000 vials are expected on 20.08.2021 and in the amount of 85,000 vials are expected until August 31, which will be promptly shipped to all regions.

Provision of the drug "Tocilizumab" (Actemra)

"Tocilizumab" is included in the Clinical Protocol for the diagnosis and treatment of coronavirus infection COVID-19 in adults, in two dosages of 80 mg and 200 mg.

It is prescribed to the patient only when signing an informed consent. The drug is prescribed on the basis of a decision of a medical council, when the potential benefit of the drug exceeds the potential risk for the patient.

The drug Tocilizumab for COVID-19 is used only in seriously ill patients with COVID-19, when a cascade of inflammatory reactions is triggered with respiratory failure, which this drug can interrupt.

The Single distributor in the framework of the provision of GVFMC at the inpatient level supplies the drug "Tocilizumab" under the trade name "Actemra" in three dosages (two dosage forms) for 2021. It should be noted that in addition to the treatment of CVI, the drug is also used in other nosologies, both at the inpatient and outpatient levels.

The delivery of the medicinal product from the warehouses of the Single distributor to the medical organizations is provided according to the schedule specified in the Contracts.

The Single distributor, taking into account the additional volume declared by medical organizations, purchased the drug Tocilizumab (Actemra) in the amount of 7,043 vials for 2021 (taking into account the additional volume, an increase of 2 times compared to the application at the beginning of the year).

On August 2, 2021, the Supplier delivered the drug in the amount of 1113 vials ahead of schedule to the warehouses of the Single Distributor.

As of August 19, 2021, the Single distributor delivered Tocilizumab (Actemra) to medical organizations of the republic in the amount of 5,533 vials.

Due to the epidemiological situation, in order to meet the additional needs of medical organizations, the Single distributor has worked out the issue of additional supply of "Aktemra" in the amount of 1277 vials in two dosages. The additional volume is expected to be delivered to the warehouses of the Single Distributor by September 15 this year.

Currently, in the regions of the country there is an agiotage among the population requiring the use of the drug without the appointment of a consultation of doctors. Relatives of patients who are in hospitals put pressure on doctors, independently purchase the drug and transfer it to a medical organization. Repeatedly, hospital doctors expressed outrage at the intervention of the population in the course of treatment. The population, unreasonably, posts complaints on social networks about the lack of a drug or the refusal of its appointment by doctors.

According to the National Institute of Healthcare of USA, the Improvement of Medical Care in the United Kingdom, there may be any advantage of tocilizumab only in patients with the most serious progress of Covid-19, if this drug is prescribed in the so-called "therapeutic window", when any developing organ dysfunction may be more reversible.

The issue of providing medicines for the treatment of coronavirus infection is under special control of the Government of RK.

As part of the fight against coronavirus infection, medicines are shipped to medical organizations of the country as a priority by the Single distributor.

Since last year, medicines have been shipped to the country's medical organizations continuously according to the schedule, according to the protocol for the diagnosis and treatment of coronavirus infection.

It is worth noting that the Single distributor purchases medicines in the volume formed by medical organizations and supplies them in accordance with the delivery schedule under contracts.

The shipment of medicines is carried out ahead of schedule, at the request of medical organizations.

In addition, for the uninterrupted supply of these drugs, medical organizations send additional requests for purchase and shipment ahead of schedule on a daily basis, which are processed promptly.

The Single distributor constantly monitors the availability of medicines, both in the warehouses of the Single distributor and in medical organizations.

In addition, the Public control after the appeals of the population, monitored the availability of medicines in medical organizations of the country. Monitoring of Public control has shown that medicines are available in hospitals in the regions, and in sufficient quantities.

We remind you that for all questions of free medical provision, you can contact the contact center of "SK-Pharmacy" LLP by the short number 1439 (all calls are free of charge).

In order to prevent the spread of coronavirus infection, the Single distributor has taken a number of the following measures to create stocks of medicines in the warehouses of the Single distributor for timely and prompt shipment to medical organizations.

First: A monthly stock of drugs for the treatment of CVI has been provided in medical organizations, since the beginning of the year, drugs for 15.4 billion tenge has been shipped.

Second: A 2-month replenished stock of drugs was provided at the HUBs of a Single distributor for 38 positions of medicine for the treatment of Covid-19 in the amount of 3.32 billion tenge.

Third: 5 names of medicines within the framework of the ODP were shipped in full  (antipyretic drugs: Paracetamol and Ibuprofen, anticoagulants: Rivaroxaban, Apixaban and Dabigatran).

Fourth: As part of the intervention in the retail network, a 2-month stock of 26 medicine in the amount of 1.8 billion tenge was formed  and 10 million masks were purchased from 8 DP, according to the requests of the Akimats of the regions.

Fifth: Stocks of disposable protective suits (humanitarian aid) are provided, 200 thousand are stored at the HUBs of the Single distributor.

Sixth: A stock of disposable medical gloves has been formed at 4 hubs of the Single distributor, within the framework of a signed memorandum with "Chevron" company  on the provision of humanitarian aid in the amount of 10 million pairs.