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Explained | E-pharmacies are signing bulk deals to acquire COVID-19 vaccines – but are they allowed to do so?

Prashant Tandon, founder and CEO of 1mg, said they have roped in 600 corporates as partners and are now in talks with apartment complexes, societies and local clinics to provide vaccinations.

May 04, 2021 / 04:23 PM IST
Jefferies India in fact notes that private vaccinations in India can generate up to $1.4 billion in revenues in FY22 – with the vaccine purchase ratio at 50:40:10 for Centre, states and private sector, respectively. (image: AP)

Jefferies India in fact notes that private vaccinations in India can generate up to $1.4 billion in revenues in FY22 – with the vaccine purchase ratio at 50:40:10 for Centre, states and private sector, respectively. (image: AP)

E-pharmacies are in a race to secure deals with corporates, old-age homes, small clinics and residential complexes as the Indian government opened up COVID-19 vaccinations for the private sector from May 1.

The development is being viewed as a $1.4 billion opportunity in FY22 for private healthcare service providers and talks are on with manufacturers — Bharat Biotech (homegrown Covaxin), Dr Reddy’s (imported Sputnik V), and the Serum Institute of India (AstraZeneca’s Covishield), for the stock, Mint reported.

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Is there interest?

Prashant Tandon, founder and CEO of 1mg, told Mint that they have signed over 600 corporates as partners and are now in talks with apartment complexes and societies and local clinics to provide vaccinations.

COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Practo, a digital health services company, saw expressions from 500 corporates for the first phase of its ‘Corporate Suraksha’ vaccination programme launched on May 3.

Jefferies India in fact notes that private vaccinations in India can generate up to $1.4 billion in revenues in FY22 – with the vaccine purchase ratio at 50:40:10 for Centre, states and private sector, respectively.

Permissions worked out?

It was earlier reported that health aggregators were expecting to join the country’s expanded vaccination drive and that players are in talks with the Centre-run CoWin platform to integrate systems and ensure that all vaccinations are counted.

"We are waiting to get some clarity from the government as to when and how the private sector can participate; at 1mg we are keen to participate," Tandon told Moneycontrol. He said that besides vaccines, the company has put in place four key things like information about the vaccine, administration, supply chain and doctor consultation for a successful rollout.

It isn't 1mg alone, other private sector players such as Apollo Hospitals, Portea Medical, Medlife, Reliance-Netmeds,and  Pharmeasy have evinced interest to be part of COVID-19 vaccination, but are awaiting more clarity from the government.

But the government has not yet given any indication of allowing private sector participation in the COVID-19 vaccination drive.

Also Read | Covid vaccine production and availability: What we know so far

Is participation likely to be approved?

Vaccinations have so far been opened up for private hospitals and clinics in India. But government sources are divided on whether pharmacies, clinics and e-pharmacies will be allowed. By regulation, pharmacists are not allowed to administer vaccines.

However, an official told the Hindustan Times that since this was allowed for flu shots, it could be opened up for COVID-19 jabs too – but with riders.

“This is something that was also done for the influenza vaccine; those who can pay are allowed to access the vaccine in private (market) with certain riders,” said a senior official, who is part of the vaccine delivery process.

On the other hand, another source told the Times of India that this is unlikely since COVID-19 vaccines are so far only listed for “emergency use”, which removes the possibility of over-the-counter purchases.

"COVID vaccines are allowed under emergency licensure and, therefore, they cannot be sold at chemists. It is important to administer them in a proper set-up and follow the guidelines during immunisation. Besides, all these vaccination centres, including the ones at workplaces, are linked with AEFI management centres to ensure identification and investigation of any adverse reaction," an official said.

While the government allowed the sale of COVID vaccines in the open market from May 1, the shots would not be available for sale at chemists or pharmacies. Only hospitals and approved vaccination centres can administer the vaccines.

Another source told the Business Standard in January that pharmacies’ participation is already under consideration.

“We want the COVID-19 vaccine drive to be a mass movement and we would need participation from all walks of life. Pharmacists, too, are likely to be roped in,” said the official in New Delhi.

Some are of the opinion that pharmacists will be allowed to join in the efforts only if India is able to secure enough vaccines.

“The involvement of pharmacists will depend on the number of doses India gets,” officials told Mint, adding that even if India gets enough doses, training will be a key part of the plan.

Also Read | When should you get hospitalised? Health Ministry lists signs and symptoms

Is there precedence?

By regulation, pharmacists are not allowed to administer vaccines. A move in this direction would likely require amendment or caveats to existing rules.

Pharmacies do provide regular vaccine shots for flu, pneumonia and hepatitis-B, Tandon told Moneycontrol, adding: "We do vaccinations for flu shots, pneumococcal vaccine and hepatitis-B, we have the expertise.”

He added that training is also something they have taken into account. "What we are doing now is we are investing in setting up a cold chain for vaccine supplies; currently we have 500 trained technicians who can administer the vaccine, we are training a network of 5,000 to 10,000 vaccinators, we are in touch with a bunch of vaccine manufacturers for possible tie-ups,” he added.

Besides India, the US is using its 'The Federal Retail Pharmacy Program' for COVID-19 vaccination, where the government has collaborated with 21 national pharmacy partners and independent pharmacy networks to increase access to vaccination across the country, as per the US CDC.

Support to understaffed healthcare system

The move would infuse human resources in form of doctors, clinics and healthcare workers into the healthcare system beyond the 7,000 government and 7,000 private centres offering vaccinations at present. However, players are still awaiting clarity on Co-WIN integration.

Jagannath Shinde, chairman, All Indian Origin Chemists and Distributors told BS that the country’s 800,000-odd pharmacies would “enthusiastically participate if asked”.

“If asked to participate, they are likely to be enthusiastic. Pharmacists are already training people to administer insulin injections. They are trained to administer a basic injection. We can plan to have refresher courses for the pharmacists and select a set of pharmacies in every city which would administer the COVID-19 vaccine,” Shinde added.

Rajiv Singhal, general secretary of All India Organisation of Chemists and Druggists also told BS that they are “ready to come forward if the training is given”. He also noted that pharmacists “know very well how to maintain the cold chain and to keep the vaccine intact”.

Gurpreet Sandhu, president, Council for Healthcare and Pharma and founder, Reva Pharma, said that while training will be needed and there is a requirement to change related laws and regulations, “8 lakh-strong pharmacists could play an important role in this”.

Experts are also of the opinion that adding pharmacists to the mix will allow larger coverage – subject to proper and mandatory training.

“Training must include administering all types of injections—intramuscular, intravenous, subcutaneous, intradermal—so that the trained resources can be used for all types of vaccination programmes. They must also be trained for management of all untoward and adverse reactions to an injection," Raghavendra Prasad TS, founder, StepOne said.

Follow our full COVID-19 coverage here

Jocelyn Fernandes
first published: May 4, 2021 04:14 pm