‘If your hospital's doctor prescribed recombinant factor, that's what patient should get': HC pull up govt

Indian Express

25-07-2025

Since 2023, 37-year old Mukul Gandhi, a hemophilia patient in Delhi, has been rushing to Jaipur to get a dose of recombinant factor drug. Exasperated, he, along with a few other hemophilia patients, moved the Delhi High Court last November.
Eight months on, the Delhi government, on July 14, assured the HC that it will proactively ensure that adequate stock of recombinant factor injections are made available in the Capital's hospitals. It also directed the government 'to ensure that adequate numbers of haematologists are recruited and deployed in hospitals run by GNCTD to attend to the patients'.
Gandhi was diagnosed at AIIMS New Delhi with hemophilia when he was three years old – a cut during his mundan ceremony had resulted in incessant bleeding.
While crossing paths with others in a similar situation, his parents came to know of an NGO that ensures availability of fresh frozen plasma (FFP) for hemophilia patients, the prevalent therapy at the time. Over time, the more advanced therapy of recombinant factor, also known as Antihemophilic Factor (AHF), was introduced and made available as therapy for hemophilia patients in India.
Speaking to The Indian Express, Gandhi said, 'Between 2013 and 2019, government hospitals in Delhi were administering recombinant factor therapy. However, after 2019, we started seeing irregular availability of recombinant factor – held to be scientifically more efficacious than plasma… Many government hospitals started seeing plasma-derived factors being made available instead.'
'We would also suffer side effects of the plasma therapy, such as nausea and nose bleed. By 2023, we started witnessing an acute shortage of the recombinant factor therapy in Delhi's government hospitals. Twice a week, I would take a bus from Dhaula Kuan to Jaipur, which was offering a variety of recombinant factor therapies. While the recombinant factor therapy is easily available in tier 2 and 3 cities such as Jaipur and Haridwar, it is not available in the National Capital,' he added.
On July 14, the Delhi government, while admitting to have witnessed a supply shortage of the recombinant factor therapy, brought two experts to the HC – State Blood Cell officer Dr Seema Kapoor and Hemophilia in charge Dr Sunita Aggarwal at Lok Nayak Hospital. They impressed before Justice Datta that from their experience, they have seen 'no difference in efficacy between recombinant or plasma… techniques are so much developed that efficacy is same'.
Justice Datta, however, countered, 'I would generally accept what you have to say. But the court's concern is only one, when doctors prescribe recombinant, it should be available… if your hospital's doctor has prescribed recombinant factor, then that's what the patient should get… The court isn't competent to get into this but only thing is if recombinant is prescribed it should be available.'
The government then informed the HC that 'currently, there are adequate stocks of recombinant factor injections'. It went on to assure that 'proactive efforts shall continue to be made to ensure that there is adequate stock of recombinant factor injections in future as well'.
However, Gandhi – represented by advocate Amit Khanna –pointed at other systemic issues faced by hemophilia patients.
'Most government hospitals in Delhi do not have hemophilia daycare centres and there is no dignity in the way we are treated. Hematologists are not available, which is essential since they will be the ones deciding on the dose, in accordance to the patients' age, weight and other factors. Instead, this is being done by general medicine doctors.'
'At Lok Nayak Hospital, my doses were not given according to my weight. After being administered a dose, they would ask me to come again in 12 hours for the next one. Given our condition which already makes us weak and prone to fatigue, this is harassment…,' said Gandhi, who works in a Delhi-based tendering company.
Owing to hemophilia, which has caused internal bleeding over the years making his joints weak, Gandhi has 69% disability. He said that he was advised knee replacement surgery around five years ago but has been unable to consider the same in the absence of a steady supply of recombinant factor therapy.
'There have been instances where my knees got locked while crossing the road. Any surgery means I will require several doses of the recombinant factor… I have postponed the surgery as there is uncertainty over the availability of the drugs,' he added.