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Thursday, April 30, 2009

Taranaki Locks Down Tamiflu Supplies

New Plymouth's medical officer of health Dr Penny Hutchinson, has restricted supplies of Tamiflu within the Taranaki DHB area.

The move was thought to be independent of the MOH's directives and none of the other 20 DHBs are thought to have followed Taranki's example.

There are only 200 doses currently available in the region and another 800 on order.

Ever since Monday NO prescriptions OR counter sales of the drug have been permitted unless the request carries an authorisation number from Dr Hutchinson.

Dr Hutchinson's action seems to have added another unnecessary layer of bureaucracy and could potentially slow down the speed at which infected people access the anti-viral drug whilst in the early stages of illness, therefore increasing the risk of further transmission. Her action also prevents people from accessing preventative doses of the drug prior to travel to infected countries.

Pharmacies were first informed of the action when their stock was requisitioned under the Civil Defence Emergency Act 2002 on Monday.

Taranaki has 17 people in isolation and 3 suspected cases.


Some DHB's Ignored MOH Advice to Stockpile Anti-Virals

November 2005 the NZ Ministry of Health issued advice to District Health Boards to source and build up supplies of Tamiflu for the treatment of H5N1/Bird flu

Some DHBs decided not to do so, citing concern over the shelf life of the drug and no doubt were concerned about the cost of buying something that could expire before it was needed.

(Recent information is that shelf life of Tamiflu can be extended from 5 to 7 years if it is stored correctly and tests confirm that it has remained stable)

In March 2006 Bay of Plenty District Health Board chairwoman Mary Hackett told the Bay of Plenty Times

"One of the problems is that Tamiflu has an expiry date. If we do stockpile antibiotics, we are turning them over because we use a lot of antibiotics. But the Tamiflu we are not using for anything else,"

The board said it was counting on the Ministry of Health to distribute its stockpile of Tamiflu should a pandemic hit.

At the time news reports stated that Wellington, Hawke's Bay, Hutt Valley and Taranaki had extra supplies of Tamiflu, and that 4 others were ordering supplies.

In 2008 The MOH issued "National Health Emergency Plan, National Reserve Supplies and Usage Policies" in which it said that each DHB board only holds 200 courses of the national reserve of Tamiflu, authorised for immediate use.

It went on to state
"DHBs generally do not hold significant additional stocks of Tamiflu beyond the 200 course allocation. Accordingly national reserve stocks will be mobilised and made available as first response supplies in case of a pandemic or threatened pandemic"

Which raises the following questions:

* Why Taranaki DHB still only had 200 courses of Tamiflu?

* Why it felt the need to place restrictions of the prescription and sale of Tamiflu when national reserve stocks will be released in the event of a threatened pandemic? There is no mention in the MOH plan of district health boards needing to use the Civil Defence Emergency Act 2002 (CDEA) to requisition stock from pharmacies.

* Has the national reserve stock been released or not?

* Who is the national reserve stock being reserved for?

* Is Taranaki DHB holding back its 200 doses for its own staff?




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