This is an interesting artical which illustrates the large volumnes of antivirals about to expire - combined with deminishing tamiflu resistance profile - this is a great opportunity for stockpile rebalancing which has been talked about a lot on this tread. the artical illustrates that govts arnt going to simply abandon there strategic antiviral stockpiles simply because the last pandemic was mild - or times are a little tough .If anything as these stockpiles need renewing the market is set to jump dramatically for relenza - until lani is approved in the west it is after all the only fully effective antiviral on the market.
Expiry of antiviral stockpile won't leave Canada without pandemic defence: Health officials By Philip Ling, Canwest News Service July 5, 2010 Comments (1) ?Story?Photos ( 1 ) Health spokesman David Jensen said "work is currently underway with the federal government and other provinces and territories on future replenishment and stockpile management strategies."Photograph by: Leonhard Foeger, ReutersOTTAWA ? More than nine million doses of antiviral medications in the country's stockpile ? three million of which were set aside to be used in the event of a "national emergency" ? will expire by the end of this year, but health officials say they will still have enough drugs on hand if an influenza pandemic strikes Canada.
Of the 23.8 million doses of antiviral medicines in the federal National Emergency Stockpile System ? comprised of oseltamivir (known as Tamiflu) and zanamivir (Relenza) ? about three million will expire at the end of 2010. Tamiflu that was manufactured prior to 2008 carries a five-year shelf-life.
The Public Health Agency of Canada "is discussing options with the supplier" about what to do with antivirals that have reached their stated shelf life, spokeswoman Charlene Wiles said in an e-mail. Options include purchasing new antivirals and disposing of the expired product, or returning nearly expired antivirals to the manufacturer in exchange for new antivirals with a seven-year shelf life at a reduced cost.
A separate plan to reprocess the existing stock ? extracting the active agent from Tamiflu tablets and capsules to prolong its shelf life ? has yet to receive regulatory approval.
The mission of the emergency stockpile program is to provide a "rapid response to an emerging pandemic."
Wiles said that, despite the fact that more than 10 per cent of the federal stockpile is set to expire this year, a review conducted in March indicated that Canada will still have enough drugs on hand to meet the terms of the country's pandemic influenza plan, which suggests holding enough antivirals for 17.5 per cent of the population.
This emergency supply is considered a backup to the regular provincially or territorially administered stockpile, known as the National Antiviral Stockpile.
The useful life of some of this stockpile, comprised of 58 million doses of antiviral medications distributed to provinces and territories on a per-capita basis, is also set to end. About six million of those doses have expired, or will expire this year.
In British Columbia, where 9.7 million doses of Tamiflu are currently on hand, about three million doses were going to expire this year but have already been replaced according to a contract between the province and the manufacturer, said B.C. Centres for Disease Control spokeswoman Ritinder Harry.
No similar replacement scheme is in place in Ontario. Of the 22.2 million doses of Tamiflu in the provincial stockpile, 1.4 million doses have already expired and another 10 million will expire next year. Remaining inventory includes expiry dates that range up to 2016. The province also has 6.4 million doses of Relenza on hand.
Ontario Ministry of Health spokesman David Jensen said "work is currently underway with the federal government and other provinces and territories on future replenishment and stockpile management strategies." Until then, he said, Ontario is not currently discarding any Tamiflu supply.
Vaccines and antivirals are the cornerstones of Canada's strategy to fight an influenza pandemic.
During last year's flu pandemic, the World Health Organizations said people in "at-risk groups" ? including pregnant women, children under two and people with underlying conditions such as asthma and other respiratory problems ? should be treated with antivirals as soon as possible when they have flu symptoms to prevent progression to severe disease.
People who were not in an at-risk group but who had persistent or rapidly worsening symptoms were also told to be treated with antivirals.
About 4.5 million doses of antivirals from provincial, non-emergency stockpiles were used during the H1N1 outbreak, PHAC said.
Meanwhile, provincial and federal governments are also debating tossing away millions of dollars worth of H1N1 vaccine because it was not used during swine flu season and will soon expire.
Governments had planned to keep much of the leftover vaccine in case of another outbreak, because doses were supposed to be good for 18 months. But in April, Health Canada abruptly reduced the best-before date to only six months because the adjuvanted H1N1 antigen was shown to decline in strength over time, catching many provinces off guard.
Now, Manitoba stands to lose $2 million worth of excess vaccine; Saskatchewan might have to dispose of 470,000 unused doses, at an unknown cost; and in B.C., 2.5 million doses worth $20 million are set to expire.
