Disease experts warn against hoarding Tamiflu

Oct 31, 2005 (CIDRAP News) – Two major organizations of infectious disease experts today warned the public against hoarding oseltamivir (Tamiflu), saying the threat of an influenza pandemic is not high enough to warrant it.

"The threat of a pandemic to the American people is so low right now that it simply doesn't justify personal stockpiles of antivirals," said Leonard Mermel, DO, SCM, president of the Society for Healthcare Epidemiology of America (SHEA). "We need this drug to treat sick people who will suffer from human strains of flu this winter." He made the statement in a joint news release from SHEA and the Infectious Diseases Society of America (IDSA).

The statement follows recent reports of people trying to stockpile the antiviral drug for protection in case a flu pandemic erupts. Scores of governments are stockpiling oseltamivir, but supplies are limited and production is slow. Last week the manufacturer, Roche, suspended shipments of the drug to US pharmacies in an effort to prevent hoarding and save supplies for those who will need it for seasonal flu this winter.

Oseltamivir and zanamivir (Relenza), called neuraminidase inhibitors, are the only antiviral drugs considered likely to be of some help if the H5N1 avian flu virus leads to a human flu pandemic.

IDSA President Martin J. Blaser said in the news release, "It's important to keep in mind that there is no pandemic right now. Even the H5N1 virus that is currently circulating in Asia and Europe primarily causes a disease affecting birds. There have been very few cases of bird-to-human transmission. Most of those who became sick were in very close contact with poultry."

In a position statement also issued today, IDSA and SHEA said, "Personal stockpiling would likely lead to inappropriate use and wastage, as well as foster antiviral drug resistance emergence under some circumstances."

The groups suggested that healthcare facilities consider building a rotating stockpile containing about five times as much oseltamivir and zanamivir as they need in an average flu season, since the shelf life of the two drugs is about 5 years.

"Given the current shortage of antiviral drugs, institutions should not stockpile drug for prophylaxis of health care workers, as this strategy requires much greater drug supplies than early treatment, and could deplete the reserve necessary for treatment on a national level," the statement adds.

US officials say they currently have a stockpile of about 2.3 million treatment courses of oseltamivir and expect to have about 2 million more by the end of this year. The government's current goal is to have enough to treat 20 million people, which is less than 10% of the population. The IDSA advocates storing up enough to treat 25% to 40% of the population.

In related news, Canadian pharmacies today stopped cross-border sales of oseltamivir to the United States to allay public concern about the potential for shortages, according to a Bloomberg News report. In announcing the move, the Canadian International Pharmacy Association said there is no evidence of a shortage now, the story said.

Meanwhile, the South China Morning Post in Hong Kong said Roche has been talking with the Chinese government about the possibility of jointly producing oseltamivir, according to an Associated Press (AP) report today.

According to the story, Roche Chairman and Chief Executive Franze Humer said he had discussed the idea with Chinese officials. But reports in Chinese newspapers said Roche had not received any formal proposals from Chinese drug companies to produce the drug, the AP reported.

See also:

IDSA-SHEA position statement

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