An antiviral insurance plan for pandemics

Have you stockpiled enough antiviral medication to provide doses for several hundred (or thousand) employees for about 80 days? Does your stockpile include more than one antiviral medication? Can you rotate it so it never expires?

That is a daunting task for the nation's hospitals — and an expensive one. To help address that challenge, Roche Pharmaceuticals of Nutley, NJ, maker of Tamiflu, and GlaxoSmithKline of Philadelphia and Research Triangle Park, NC, maker of Relenza, offer special "reservation" and stockpiling programs for employers.

In the Roche Antiviral Protection Program, employers can reserve Tamiflu for about $6 per 10-day regimen per year. (The annual fee may rise after the third year of the program.) In the event of a pandemic, Roche provides the doses to the employer at the prevailing wholesale price. The pharmaceutical giant says the doses will be delivered within 48 hours "under most circumstances."

Employers can opt out of the program at any time without penalty, the company says.

The Relenza Pandemic Readiness for Employers Program (PREP) offers two options. Employers may purchase Relenza doses at a discounted price and store them at the pharmaceutical company's facilities. Or they may reserve 10-day regimens for an annual fee of $6 and lock in a future purchase price.

The reservation programs are similar to a pandemic insurance plan for hospitals, says Ben Schwartz, MD, former senior science adviser with the National Vaccine Program Office in Washington, DC, who coordinated the development of the HHS Guidance on Antiviral Drug Use During an Influenza Pandemic.

They help hospitals avoid concerns about drugs becoming outdated, he notes. "If a new drug came out or resistance occurred, [employers] could simply let the stockpile lapse," he says.

If a hospital chooses to maintain its own stockpile, it can save money by working through the public health department, Schwartz says. "If a state would combine all of the orders from the health care sector and then submit those under the federal contract [for antivirals], the cost would be far less than if each hospital were to individually purchase the drug through the private sector," he says.

For both companies, release of the stockpile is triggered when the World Health Organization declares a Phase Four pandemic alert (human-to-human transmission) or upon request of the employer.

(Editor's note: More information on the Roche stockpiling program is available at www.pandemictoolkit.com/tamiflu-supplyordering/stockpiling-dilemma.aspx. Information on the GlaxoSmithKline program is available at http://us.gsk.com/html/media-news/pressreleases/2008/2008_us_pressrelease_10131.htm.)