COVID-19 Impact on Hydroxychloroquine in Chemicals and Materials Industry

INTRODUCTION
The primary use of hydroxychloroquine is in the prevention and treatment of malaria, particularly in cases of malarial infection caused by chloroquine-sensitive bacterial strains. It was first approved as a medicine back in 1955 by the United States and gained popularity ever since. By 2017, with more than five million prescriptions, it was not only the 128th most widely used drug in the United States, but also one on the List of Essential Drugs of the World Health Organisation.

Its sulphate salt, hydroxychloroquine sulphate, is the generally used form and is commonly sold under the brand names Plaquenil, Hydroquin, Axemal (in India), Dolquine, Quensyl, and Quinori for administration via the oral route. However, a proper amount of food intake is required before its oral administration to prevent the stomach from being upset.

USES
Although the primary use of hydroxychloroquine is against malaria caused by mosquito bites, it is also a disease-modifying anti-rheumatic drug (DMARD). DMARDs are a class of medication used to treat certain auto-immune diseases such as rheumatoid arthritis, juvenile idiopathic arthritis, and lupus. It has the ability to alleviate the pain and swelling, prevent joint damage, and could reduce the risk of long-term disability in the case of arthritis, and can reduce skin problems in lupus as well.

MECHANISMS OF ACTION
The precise mechanisms via which hydroxychloroquine exerts its activities are unknown. Scientists believe that hydroxychloroquine is a weak base that inhibits the polymerization of heme in the parasite by concentrating in its acid vesicles. This mechanism is similar to that of chloroquine, which is another anti-malarial drug. Hydroxychloroquine can inhibit certain enzymes in bacteria by interacting with its DNA. This fact makes it effective against certain strains of bacteria such as Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax, unlike chloroquine.

In addition to its anti-malarial activity, hydroxychloroquine could also interfere with the communication of cells in the immune systems, thereby exhibiting DMARD characteristics and preventing autoimmune diseases.

SIDE EFFECTS
Hydroxychloroquine is typically well-tolerated and is not known to cause many side effects. The most common side effects include nausea, diarrhoea, vomiting, loss of appetite, dizziness, and headache, which generally improve with time. Serious side effects include slow heartbeat, symptoms of heart failure, mood swings, hearing impairments, easy bruising/bleeding, infection such as sore throat and fever, muscle weakness, and hair loss. However, these are extremely rare.

In some extreme cases, which involve the prolonged intake of high doses of this medicine or where the patient is 60 years or older, side effects such as significant kidney or liver diseases and loss of vision has also been observed.

IMPACT OF COVID-19 ON HYDROXYCHLOROQUINE MARKET
The pandemic COVID-19 has created a horrendous situation all over the world, especially in the economies across the globe. The lockdown imposed to curtail the number of affected cases made the situation even more challenging for all economic sectors, especially in terms of growth. Although markets are recovering, the pace is lackadaisical.

However, for the market and economies supported by the production of hydroxychloroquine, the COVID-19 pandemic was a boon in disguise.

For instance,

India, which is the largest producer of hydroxychloroquine (HCQ). As per an analysis done on the initial lockdown period, the exports of hydroxychloroquine dipped to USD 36 million worth of the drug till February, FY20 from USD 51 million worth of the drug in FY19.
Nonetheless, the U.S. President Donald Trump's campaign for HCQ was a game-changer for all the main players in the market as the global demand for this drug, which was previously inexpensive, surged all of a sudden. Coming back to the previous instance of India, all of a sudden the export demand increased phenomenally. India’s SAARC neighbours, such as Afghanistan, Bangladesh, Bhutan, the Maldives, Nepal, Pakistan, and Sri Lanka along with other countries such as Brazil and the United States imported this drug from India. Moreover, the central government of India itself has requisitioned 100 million tablets for internal use. Both these parameters were vital for two of the major players in this market, Ipca Laboratories and Cadila Healthcare. Both these player were able to make phenomenal growth by utilizing this situation

IMPACT ON END-USERS OF HYDROXYCHLOROQUINE
Considering the non-consequential nature of malaria in countries such as the U.S. and most of Europe, the manufacturing of hydroxychloroquine is not effective in these countries. As per the data, each patient needs a 14-tablet course. Therefore, 70 million people require around 100 million tablets for treatment.

With 67,326,947 infected people worldwide as of December 7, 2020, if proven effective against COVID-19, the market can reach substantial growth, especially in the Asia-Pacific market.

CONCLUSION
The COVID-19 pandemic has significantly affected all the manufacturing and industries worldwide. The imposed lockdown rules not only halted the production and manufacture of goods but also reduced sales across the globe to an extreme extend.

Even though this caused enormous loss for both the countries and economies, COVID-19 was a godsend bonanza for pharmaceutical industries, particularly to hydroxychloroquine industry. In the current condition, the demand for hydroxychloroquine is rapidly increasing even after hitting a halt in June 2020. If the current trend continues, this industry will achieve the predicted CAGR of 40.3% and would touch USD 5,549.65 million in profit over the course of seven years.