Pandemic debate now steered to allotting antivirals

Preplanning is key to using these drugs effectively to reduce the illness' spread.

By Victoria Stagg Elliott, AMNews staff. June 16, 2008.

During an influenza pandemic, antiviral drugs will be in short supply, and a national discussion is needed to determine how these medications will be doled out to the population, particularly for prophylaxis care, says a recent Institute of Medicine report.

"We know [antivirals] have a role in treatment, but what does society feel about who should get the drugs for prevention?" asked Andrew T. Pavia, MD, a member of the committee convened by the IOM to create the document, released April 25. "Should it be the elderly? Should it be the children? Should it be the people who we depend on for our safety?"

Much of the debate over how a vaccine for a pandemic influenza virus strain would be used already has occurred. But, members of the IOM's Prophylactic Use of Antiviral Medications During an Influenza Pandemic committee say a similar conversation regarding antivirals is crucial. In the early days of the predicted pandemic, for instance, these medications may be the only tools available to help control the illness' spread. The pandemic vaccine may take months to start rolling out. During that time, health care workers and emergency personnel should be given first priority for these drugs, but who else should get them?

"Given that scarcity is almost a certainty, and this is not a society that knows much about scarcity, we need a lot of public buy-in," said June E. Osborn, MD, committee chair.