COVID-19 Impact on CMV Infections Treatment in Pharmaceutical Industry
The outbreak of the coronavirus disease started in the city of Wuhan, China, in December 2019. Since then, it has spread horrendously throughout the world at a rapid speed, and many individuals have been affected by this viral disease. This pandemic is creating a problem for many drug manufacturing companies, including companies responsible for producing effective CMV infection drugs as different kinds of quarantine policies have been adopted by various countries across the globe.

PRICE IMPACT
India is considered one of the global leaders when it comes to drug supply to other countries. India exports 30 percent of the API’s used in the U.S., and also the majority of API’s required by different companies across the world for the manufacture of generic drugs is supplied by India. But India imports almost 65 percent of its total bulk API requirements from China for the medicine formulations. During this pandemic period, as China’s competitiveness towards India increases, they are raising the cost of their API’s, which would ultimately result in the disruption of the drug manufacturing market and increase their prices.
Moreover, India imports the majority of ganciclovir, an antiviral medication that is the first choice to treat cytomegalovirus infections from China, Switzerland and Germany. During this lockdown, the import of materials has been banned, which will undoubtedly lead to a rise in ganciclovir prices. The lockdown policies have also hampered the importance of medical devices and the raw materials required to manufacture medical devices.

IMPACT ON DEMAND
CMV infections are mainly related to organ transplants and bone marrow transplants, and it has been found that after the lockdown due to COVID-19, the rate of these transplants has dropped considerably showed a decline in the global CMV virus infections treatment market. The demand for drugs was not much, and it resulted in stockpiling. But after a certain period, the situation was back to normal, and the demand for the drugs also rose up.
Due to the lockdown regulations, many drug manufacturing companies have been suffering to deal with the market demand. The market demand for generic drugs will always be high, so there are few steps that the government has taken to deal with the demand.
For instance,
• The cabinet approved an investment of USD 13.94 Billion to increase APT production, out of which USD 4.2 billion was for mega parks and USD 9.4 Billion supported industry domestic production efforts.
• Almost 27 API’s were planned to be made through chemical synthesis and 26 API’s were to be made through fermentation. API’s for drugs such as Ganciclovir and Valganciclovir are also supposed to be manufactured.
• The government then started a production linked investment scheme or a PLI scheme for domestic production of API’s.
The lockdown situation due to COVID-19 has also affected the demand for diagnostic diseases such as PCR machines used to diagnose both coronavirus and CMV infections. As PCR is the only way to diagnose Coronavirus disease, its demand is going to increase rapidly. Also, there are only two ways to diagnose CMV infections: serological test and the other is PCR test and if the infection is diagnosed, there will be no treatment procedure to follow up, so the PCR machine is an absolute necessity for diagnosing these diseases.
This shows that the initiative taken by the government is helping to tackle this COVID-19 situation as API’s needed for CMV infection drugs are now starting to get manufactured domestically and the situation is likely to get better in the future. Also, due to this coronavirus disease, the use of PCR machines will get very high, which is also used to diagnose cytomegalovirus infection.

IMPACT ON SUPPLY CHAIN
COVID-19 has led to a disruption in the supply chain of drugs. Lockdown policies in different countries have resulted in pharmacies closing walk-in customers to prevent the spread of the disease, leading to increased demand for home delivery and mail delivery systems. This led to a significant delay in the supply of the drugs. Also, during the lockdown period, the market for online delivery of drugs has risen, which is expected considering the situation.
As many pharmaceutical companies are dependent on China for the supply of API’s their recent price hike has disrupted the manufacturing process of the drugs. Due to this, many companies are looking to diversify their API gathering according to their geographic location.
The investment made by the government of India for the domestic manufacturing of API’s will make the future of generic drug manufacturing a bit better. The API’s for drugs such as Ganciclovir and Val ganciclovir will also be manufactured, so the medicine formulation won’t be a problem.
A complete ban on the import of different goods from other countries has completely disrupted the supply chain.
The leading companies of the CMV infection market have taken strategic steps to supply their drugs to people worldwide adequately.
For instance,
• Roche Holding AG, a leading manufacturer of Val ganciclovir stated that governments worldwide should work closely with the industries to keep manufacturing and supply running. Roche also increased their manufacturing capacity to maximize production.
• Fresenius kabi, the leading manufacturer of Foscarnet used for the treatment of cytomegalovirus infections, is dedicated to protecting its workforce in all aspects and has increased safety measures for its employees across their organization so that the supply can be maximized without any problem.
This shows that even if the COVID-19 situation is disrupting the supply chain of API’s and the manufacture of drugs, the government of India and different major companies are creating hope for the proper supply of drugs.

STRATEGIC DECISIONS BY MANUFACTURERS
COVID-19 can hamper the production of the drugs for CMV infection, but it also allows companies to improve their business by different means. As pharmaceutical company always does, they tend to find newer and better ways to treat a disease, same is the case for CMV infections treatment. Always bringing better solutions in the market would increase their business efficiency.
For instance,
• Fresenius kabi introduced their first-ever generic for Foscarnet sodium injection, which lowered the cost for treating CMV infected immune-compromised patients
• Takeda Pharmaceutical says that their investigational drug TAK-620(Maribavir) has demonstrated efficacy against Cytomegalovirus (CMV) infections. This analysis was based on Phase III clinical trials

CONCLUSION
As this pandemic situation has resulted in many restrictions around different places in the world but the market leaders of CMV infections treatment has been able to manage their drugs stock. The supply chain has been destroyed as most of the drug manufacturing company did not get their API’s for the proper drug formulation, but the government of India took several steps and as well as different companies which will help them to get their needed API’s and adequately carry out the drug manufacturing process. By increasing the raw materials price, the companies can maintain their overall revenue. Thus different companies of this CMV infections treatment market find their ways to deal with this pandemic situation.