State weighing option to buy more flu anti-virals

BOISE – Idaho officials won’t decide whether to order additional stockpiles of anti-viral influenza medicines until they know whether the federal government will let Idaho’s share of existing stocks be stored in-state, said Tom Shanahan, spokesman for the Idaho Department of Health and Welfare.

As part of its preparations for a possible flu pandemic, the federal government is stockpiling Tamiflu and other medications designed to reduce the symptoms associated with influenza at distribution sites nationwide.

The Bush administration plans to buy enough anti-virals to treat 44 million people, and Idaho has been promised more than 203,000 courses of the drugs. States can buy more if they want, with the federal government paying a quarter of the cost, up to a prescribed amount for each state. In all, states could use the subsidy to buy anti-virals for an additional 31 million people.

With more than 1.3 million people living in Idaho, 203,000 courses of antiviral drugs would only be enough for an initial response to a pandemic outbreak, Shanahan said.

One course is enough to treat one person with influenza. Idaho has the option to buy more than 143,000 additional courses, which would bring the state total to enough medication to treat more than 347,000 people.

But each additional course purchased would cost Idaho $14.43 after the federal subsidy, for a cost of a little over $2 million if Idaho were to buy the maximum allotment.

The states have until Aug. 1 to decide whether to purchase additional stockpiles, and Idaho leaders won’t make that decision until they know just how close by they’ll be able to store the existing stockpile, Shanahan said Thursday.

Right now, state leaders are trying to get U.S. Health and Human Services Secretary Mike Leavitt to clarify where the 203,000 guaranteed courses may be stored, Shanahan said.

“Basically where we’re at now is when Leavitt was here he told Gov. (Jim) Risch that we could store the 203,000 in-state so that if something did break out we could immediately react,” Shanahan said. “But since, we’ve been told that it would stay in the strategic national stockpile.”

Leavitt came to Idaho in March as part of a pandemic flu summit. While here, he met privately with state leaders and spoke publicly about the risks a pandemic would pose.

“The reality is, when it comes to a pandemic, we’re overdue and underprepared,” Leavitt told about 200 state, city and county leaders during the summit. “Anything you say before it happens seems like we’re being alarmist. At the same time, anything you do after the fact seems inadequate.”

Because the additional state purchase could be kept within state borders, Idaho may use such an order to hedge its bets, Shanahan said.

“You always worry about getting it fast enough in a pandemic and you never know for sure what might happen, so I think we would feel more secure if we could keep it in-state,” Shanahan said.

Even if the 203,000 courses are kept out-of-state, the federal government has assured the Idaho Department of Health and Welfare that a so-called pushpack of anti-virals and other pandemic supplies would only be 12 hours away, Shanahan said. However, it’s not clear just how many courses are included in a pushpack, nor how long it would take to get the additional doses up to the 203,000 course limit.

Ultimately, it’s unclear just how effective anti-virals will be in a flu outbreak, Shanahan said. State agencies and residents would also likely be able to purchase additional antiviral courses through private pharmacies if needed, he said.