After HCQ, countries begin to call India for the humble pain and fever tablet paracetamol

India exports approximately Rs 730 crore-worth of paracetamol annually | Representational image | Flickr

New Delhi: India is in demand for its manufacturing prowess of not just hydroxychloroquine (HCQ), but also paracetamol — two drugs that have shown some promise in treating Covid-19 patients.

India produces 5,600 metric tons of paracetamol every month, while the domestic requirement is only around 200 metric tons. The rest of it is exported to countries such as Italy, Germany, the UK, US, Spain and Canada, amounting to an estimated Rs 730 crore each year.

The Narendra Modi government Thursday approved the export of paracetamol, commonly used for treating fever and body aches, to the UK as a part of a global cooperation strategy.

Thanking Modi on Twitter, Acting High Commissioner to India, Jan Thompson said global cooperation is critical in the fight against Covid-19, and added that the UK and India have a track record of working together.

The UK has recorded over 60,000 cases of Covid-19 infections, including its Prime Minister Boris Johnson.

India has been receiving queries for the supply of paracetamol from other countries as well, such South Korea, US and Canada.

“We are receiving queries for the drug across the globe including Sri Lanka and Europe. However, presently, the export of the drug is restricted and requires export permission,” said a government official from the Department of Pharmaceuticals.

Last week, India was in the spotlight over its restrictions to export HCQ but partially lifted them later.

Why paracetamol?

Paracetamol is an active pharmaceutical ingredient (API, the raw material used to manufacture drugs) for branded medicines such as Crocin, Calpol and Dolo.

However, unlike HCQ, for which India runs a self-sufficient production process, the country imports intermediaries and key starting material for the production of paracetamol from Hubei, China.

While paracetamol is one of the most commonly used analgesic (pain killer) and antipyretic (fever medicine) worldwide, supply has run short globally due to the high demand. It is being used to treat the symptoms of Covid-19, which includes fever and body aches.

Globally, there are over 1.21 million people infected with coronavirus currently.

Status in India

The top players producing API in India are Hyderabad-based Sri Krishna Pharmaceuticals and Granules India and Ahmedabad-based Farmson.

According to research firm IQVIA, around 60 per cent of the domestic market for branded paracetamol is shared between GlaxoSmithKline (GSK)’s Calpol and Micro Lab’s Dolo.

The total market in India for paracetamol, including fixed dose combinations, is Rs 3,600 crore, of which the market for plain paracetamol is around Rs 1,300 crore. This includes about Rs 550 crore-worth of tablets, Rs 410 crore-worth of liquids and Rs 360 crore-worth of injectables.

India sells 545 crore tablets — 37 crore strips with an average of 15 tablets each — of paracetamol every year, according to IQVIA.

The pharmaceutical industry has assured the central government that India has enough stock to produce paracetamol over the next 5-6 months.

Govt lifts ban on paracetamol export

On 7 April, the government allowed the licensing of paracetamol and HCQ to nations badly affected by the Covid-19 pandemic. This means companies will require government permission in the form of a licence to export an order.

“In view of the humanitarian aspects of the pandemic, it has been decided that India would licence paracetamol and HCQ in appropriate quantities to all our neighbouring countries who are dependent on our capabilities. We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic,” the Ministry of External Affairs (MEA) spokesperson, Anurag Srivastava said.

In February, India prohibited the export of paracetamol along with 12 other APIs, including antibiotics, vitamins and hormone pills.