http://www.detnews.com/2005/health/0510/23/A10-357557.htm QUOTE *********************** Fears of flu push drug sales
Health officials call online purchases of large amounts of Tamiflu and Relenza 'hoarding.' ******************************** By Katy Human / Denver Post
DENVER -- Internet sales of antiviral drugs at some online pharmacies are up by 1,000 percent or more this year, and health officials, who suspect the trend is related to fear of a flu pandemic, are calling the practice of "hoarding" unethical and dangerous.
U.S. citizens are buying huge amounts of the antiviral drugs Tamiflu and Relenza online, according to several pharmacies.
"This behavior has the potential to reduce supplies that are available for seasonal flu," said Bill Hall, spokesman for the U.S. Department of Health and Human Services.
Tests have shown that Tamiflu and Relenza can disable the H5N1 strain of bird flu that has killed about 60 people in Asia this fall.
But buying the drug and tucking it into a drawer in case a pandemic strikes is a bad idea for personal and public health reasons, health officials said.
Viruses often develop resistance to drugs, especially if drugs are used inappropriately as they are likely to be when hoarded by private citizens, experts said.
Moreover, antivirals, especially Tamiflu, are in short supply this year, Hall said, and they're needed for the regular flu season.
The sole manufacturer, Switzerland's Roche Holding AG, has announced that it will build a plant in the United States. It will also consider allowing other companies to manufacture the drug.
"Their production capacity clearly can't meet demand," Hall said.
Demand by individuals over the Internet is skyrocketing.
"It's crazy," said Mark Catroppa, a vice president with CanadaMedicineShop.com in Vancouver, which has about 175,000 U.S. customers.
Last year, his company sold no more than 10 doses of Tamiflu or Relenza in any month, Catroppa said. During the past two weeks, about 400 people a day ordered the drugs.
Drugstore.com of Bellevue, Wash., declined to disclose sales amounts but reported a huge spike of Tamiflu orders this month. People ordering the drugs preventively should be aware that they may not be effective against a flu strain that does become pandemic, said Dave Daigle, spokesman for the federal Centers for Disease Control and Prevention in Atlanta.
A yet-unidentified strain of flu could end up becoming the bad one, Daigle said, and there is no way to test the drugs' effectiveness against such unknowns.
The drugs may be effective against the H5N1 avian strain today, he said, but for that virus to go pandemic, it must evolve the ability to move easily between people. Such genetic changes could also make the virus more or less responsive to antivirals, Daigle said.
The federal government is stockpiling Tamiflu, other antiviral drugs and flu vaccines to use in fighting a pandemic.
In the case of a flu pandemic, health officials would distribute medicine and vaccines from the national stockpile according to a plan, with health care providers and people who are most vulnerable to dying of flu among the first who would be treated, according to the Department of Health and Human Services.
"I understand there are people who have lost faith in the government's ability to protect them," said Gwen Huitt, infectious disease specialist with National Jewish Medical and Research Center in Denver, "but this (hoarding) is not prudent."
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It will be interesting to see how Roche AG reacts to Taiwan producing their own Tamiflu. Taiwan says they can make Tamiflu faster and cheaper and will not let patent talks with Swiss drug maker Roche AG stand in the way.
Taiwan says ready to make its own Tamiflu Sat Oct 22, 2005 4:46 AM BST167
By Alice Hung
MIAOLI, Taiwan (Reuters) - Taiwan is ready to produce its own Tamiflu, the antiviral avian flu drug, and will not let patent talks with Swiss drug maker Roche AG stand in the way, officials said.
The island's National Health Research Institute showed media late on Friday a generic version of Tamiflu produced by its laboratories, which it said was 99 percent similar to Roche's drug.
"The congress and the government in Taiwan have already decided to produce Tamiflu, starting from right now .... once we obtain the material," Su Ih-jen, head of the clinical division at the health institute, told Reuters.
The Taiwan government was among the first in the world to seek permission from Roche to make Tamiflu, but it has yet to receive an authorisation.
"We have tried our best to negotiate with Roche. It means we have shown our goodwill to Roche and we appreciate their patent. But to protect our people is the utmost important thing," said Su, a former chief of the Center for Disease Control.
Taiwan has so far been spared a serious outbreak of the H5N1 virus lethal to humans, but authorities found rare birds infected with the strain in a container smuggled from China on Thursday, the island's first case since late 2003.
All the birds were destroyed, and officials said there was little danger of the virus infecting local birds and spreading.
Taiwan made clear it would not wait for Roche's answer on Tamiflu as time is critical to prepare for a possible pandemic.
"In the case of an outbreak, if Roche cannot supply, what choice do we have?" said Wu Cheng-wen, president of the health research institute.
FASTER, CHEAPER
Wu said his research team had successfully duplicated 20 grams of Tamiflu in 18 days and would help local drug companies to mass produce the drug, which is considered the first line of defense against H5N1.
Taiwan plans to produce one to two million courses of Tamiflu for domestic use by January to March next year and has no plan to export the drug to other countries, Wu said.
The island is confident it will make Tamiflu faster and cheaper.
One million courses of locally made Tamiflu cost about T$200 million (US$5.9 million), compared with T$1 billion if purchased from Roche, Su said, adding it takes about 3 months to make one million courses.
The Taiwan government has said it is building up stockpiles of Tamiflu and aims to have enough to treat 4 percent of its 23 million people by mid-2006. The eventual goal is to have enough stock to cover 10 percent of the population.
Tamiflu is not a cure for the flu, but it can lessen symptoms if taken shortly after they first appear. Researchers warned last week that they have seen signs the avian flu virus is becoming resistant to the drug.
Sixty-one people in Asia are known to have been killed by the H5N1 virus. Experts fear it will mutate into a form that can pass easily from person to person, sparking a worldwide pandemic.
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