Antiviral stockpiling for novel strains of influenza
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Antiviral Stockpiling for Novel Strains of Influenza. Background for Stockpiling. Strategic National Stockpile ( Administered by the Centers for Disease Control and Prevention). The SNS is designed to provide supplies for a disaster

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Antiviral Stockpiling for Novel Strains of Influenza

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Antiviral Stockpiling for Novel Strains of Influenza


Background for Stockpiling


Strategic National Stockpile (Administered by the Centers for Disease Control and Prevention)

  • The SNS is designed to provide supplies for a disaster

  • Currently comprised of 12-hour Push Packages and Vendor Managed Inventory for rapid response measures

  • Other special supplies available


SNS Antiviral Stockpile Creation

  • Lack of effective vaccine creates an immediate need for antiviral drugs

  • Antiviral drugs are limited in supply and may be cost prohibitive

  • Two types of antiviral medications stockpiled and recommended for novel influenza use


SNS Antiviral Stockpile

  • Utah has been given an SNS allotment of 350,518 courses (held by CDC)

  • This allotment would treat approximately 13.6% of the State’s current population


State Antiviral Stockpiles

  • CDC has allowed states to purchase of additional courses at their contracted price with a 25% subsidized match

  • Total courses available to Utah for subsidized purchase - 246,956

  • Total cost estimates for subsidized allotment is about $3.6 million dollars (does not include storage expenses)


SNS and State Stockpiles

  • The sum of the SNS allotment for Utah and the subsidized courses provides a total of 597,475 courses

  • This would treat 23.1% of the current Utah population (one course per patient)


Issues


Stockpiling Expenses

  • Effectiveness of antiviral drugs is not clearly established for novel influenza virus strains

  • Stockpiles may not effectively be rotated to extend shelf-life

  • Shelf-life extension programs are not currently allowed at the state level


Assumptions for Public Concern

  • The public likely expects preparation efforts to be comprehensive

  • Antiviral drugs may save lives

  • Fairness in rationing and policies for use

  • Lack of a significant influenza event may discredit the use of funds – pumps at the Great Salt Lake


Allowances for Purchasing

  • States may pool money from local governments or other private organizations to purchase antiviral drugs under the federal contract

  • The State is responsible for the purchase payment and is allowed one delivery

  • A letter of intent is required by December 29, 2006 for purchase


Priorities for Use

  • Multiple stakeholders need to be unified on antiviral drug priorities for administration

  • The National Vaccine Advisory Committee has developed guidance to assist in prioritizing administration protocols

  • Limited supplies dictate antiviral drugs should be used primarily for treatment and limited prophylaxis


Equity in Rationing

  • Initial patients may exhaust stockpiles

  • Some communities may have outbreaks at later dates

  • Antiviral medications in the State stockpile might be distributed for use follows:

  • Sixty percent (60%) to be distributed according to the population of each district

  • Twenty percent (20%) distributed according to the number of general medical beds in each jurisdiction

  • A reserve of 20% be maintained at the State for distribution according to need, including coverage of priority groups identified, or for outbreak control


Planning Adaptations

  • Uncertainty requires plans be flexible, coordinated, and approved effectively

  • Stakeholder coordination requires an efficient decision making process


Recommendations

  • Pursue funding for antiviral drug purchase

  • Approve recommendations of the National Vaccine Advisory Committee for use of antiviral drugs

  • Allocate purchased stockpiles based on health district population, hospital beds, and retain a State reserve

  • Recommend that hospitals, healthcare providers, and others be allowed to purchase under the federal contract through the State

  • Develop an integrated State plan including storage, management, distribution, dispensing, accountability of use, assessment of efficacy, and adverse events


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