Antivirals for Pandemic Influenza Guidance on Developing a Distribution and Dispensing Program (2008) / Chapter Skim
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1 Introduction
1 Introduction
Pages 11-18
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From page 11... ...
To attempt to contain the pandemic and decrease mortality until a vaccine is available, the federal government, most states, and some localities plan to use antiviral medications for treatment, and if supplies permit, prophylaxis. The federal government strategy calls for the use of antiviral medications in conjunction with non-pharmaceutical interventions such as social distancing and curtailing or modifying school activities (depending on pandemic level of severity, as described in the Community Mitigation Strategy)
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From page 12... ...
In 2006, zanamivir was approved for prophylaxis in adults and children age 7 and older. Antiviral medications consisting largely of neuraminidase inhibitors are currently stockpiled by government at the federal, state, and local levels, and to a limited extent by the private sector, including some employers, health care organizations, and individuals.
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From page 13... ...
In the absence of clear answers to these and other questions, public health agencies at all levels have been making a number of assumptions in their pandemic planning. Some assumptions are based on a complete lack of information, while others are based on incomplete or inconclusive evidence; all will need to be revisited as more information and data become available.
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From page 14... ...
, and their household contacts will be pro vided prophylaxis. The following assumptions concerning the pandemic and antiviral drugs set the context for the committee's discussion of what is needed to effectively implement an antiviral drug program.
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From page 15... ...
With respect to treatment of cases and post-exposure prophylaxis of their household contacts, key planning issues include, but are not limited to, determining where drugs are dispensed; allocation and distribution of drugs to those sites; diagnostic approach for cases; strategy to enumerate house hold contacts and assess appropriateness of dispensing drugs for them; potential regulatory barriers to dispensing; and monitoring antiviral drug use and safety. With respect to prophylaxis for targeted health care and emergency services personnel, key issues include, but are not limited to, determining where drugs are dispensed; potential regulatory barriers to dispensing; labor issues that may arise from target ing some workers, but not others; and monitoring antiviral drug use and safety.
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From page 16... ...
; additional antiviral supplies would be needed for those groups if there are prophylaxis goals that include them. Finally, although the committee acknowledges the global effect of an influenza pandemic and the need for antiviral medications outside the United States, these important and challenging issues are beyond the committee's charge and require separate and in-depth treatment elsewhere.
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From page 17... ...
, modeling of antiviral resistance, and distribution and dispensing planning from the perspective of state public health agencies. At that meeting the committee received information on the following topics: lessons from experience with large-scale distribution/dispensing of drugs or administration of vaccine; decision analysis for antiviral distribution; telephone and web-based decision support and triage; antiviral stockpile planning from the perspectives of the private and public sectors, and in a publicly funded and a private health care system; and ethical principles in planning for the distribution and dispensing of antiviral medication.
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