This story is from January 22, 2017

Delhi HC asks 2 Mumbai hospitals to treat Patna TB patient with newest drug

Delhi HC asks 2 Mumbai hospitals to treat Patna TB patient with newest drug
Representative image
MUMBAI: Two city hospitals will play a significant role in the treatment of a tuberculosis-affected girl from Patna who moved the Delhi High Court for access to bedaquiline, the newest anti-TB drug in 50 years.
While the court on Friday has stated that the 18-year-old will be administered bedaquiline by Hinduja Hospital under Dr Zarir Udwadia's supervision, civic-run KEM Hospital in Parel will provide the full course of the drug.

This “peculiar“ arrangement has been necessitated as bedaquiline is available only through a limited-access government programme; 100 patients each will be treated at six approved centres, including Mumbai and Delhi. When the Patna girl went to LRS Hospital in Delhi, she was reportedly turned down because of domicile reasons, prompting her father ­ a class-III government servant in Patna ­ to move the court.
The court said the girl's treating doctor will first make an application to the Drug Controller General of India, seeking permission on a “compassionate use basis“ to bedaquiline's manufacturer Janssen Pharmaceuticals. Once the company sends its approval, Hinduja Hospital can get the medicines from KEM. In the normal course, it can take another 45 to 60 days to receive the medicines due to the paperwork involved (applying for an import licence, seeking waiver of customs duty , among others). When the medicines imported from Europe via Janssen, come in 60 days, Hinduja will return them to KEM.
“By getting KEM Hospital, the nodal centre for the bedaquiline programme in Mumbai, to provide the medicines which will then be replenished by Hinduja Hospital, the girl can get early access to the drug,“ said the girl's legal team. The domicile question has been a vexed issue. Consider the case of 21-year-old Amandeep Mokha, a Gurgaon resident who petitioned the government for bedaquiline for his severely ailing 53-year-old father in September, 2016. “We were denied access by LRS Hospital in Delhi because we are Gurgaon residents,“ said Amandeep, adding his father passed away on October 8.

Another Sikkim resident, who was denied bedaquiline by the Guwahati centre, is now hopeful. As part of the Patna girl's case hearings, the government has submitted that domicile will no longer be a criteria for access to bedaquiline.
“The domicile rule no longer stands,“ said Anand Grover of Lawyers' Collective which fought the Patna girl's case for free.
Meanwhile, the girl's father is waiting to hear from Hinduja Hospital. “We were in Hinduja Hospital last Wednesday when several tests were conducted.We returned to Patna thereafter,“ he said, adding that his daughter is in hospital with liver problems caused by drugs.
Dr Udwadia told TOI, “Her father wants her to be treated by me though they live in Patna. Despite the logistics, I don't mind this. She will get immediate access to bedaquiline as per the court ruling.“ His team member Dr Shashank Ganatra said that some results will be available by Monday . “But we need to conduct a few more tests before working on the online application process,“ he said.
Incidentally , the girl may need access to another new TB drug, called delamanid, along with bedaquiline. “We will try to start her on bedaquiline and begin her on delamanid if needed,“ added Dr Ganatra. She may thus become one of the first few patients in the country to be treated by the two new drugs together.
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About the Author
Malathy Iyer

Malathy Iyer is Senior Editor (Health) at The Times of India, Mumbai. She writes mainly on health-related subjects.

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