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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strategic national stockpile administered by the centers for disease control and prevention
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
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
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
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
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)
stockpiling expenses
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
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
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
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
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
Planning Adaptations
  • Uncertainty requires plans be flexible, coordinated, and approved effectively
  • Stakeholder coordination requires an efficient decision making process
recommendations
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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