27 July 2006

Inhaled Zanamivir (Relenza) for Anti-Influenza Drug Stockpiling Available to 50 States, DC, and 8 other Jurisdictions at Subsidized Cost.

On 20 July the US Secretary of Health and Human Services (HHS) announced that all US states, the District of Columbia, and five other U.S. territories and three Freely Associated States of the Pacific are able to purchase Zanamivir (“Relenza”), at a federally negotiated price and with a 25% federal subsidy for a specific number of treatment courses. The expense for these 59 jurisdictions may still be significant and could impact the rate of full compliance in purchasing anti-flu drugs.

The overall HHS goal is to stockpile enough anti-influenza medications (including the oral drug oseltamivir (“Tamiflu”) and the inhaled drug Zanamivir (“Relenza”)) to stockpile for 25% of the US population (75 million doses). The federal government will purchase 44 million of these medication courses and keep them centrally in the Strategic National Stockpile (SNS). The remaining 31 million courses are currently anticipated to come from the state-purchased, federally subsidized, program and to be kept in the 50 states and nine other jurisdictions.

On March 29, 2006 the US Food and Drug Administration (FDA)announced approval of inhaled Zanamivir (Relenza) for prophylaxis (prevention) of influenza A and B for children 5 years of age and older. This drug had previously been FDA-licensed for treatment of actual influenza illness.

Due to severe and sometimes fatal respiratory side effects of the drug in persons with underlying lung disease, Zanamivir is NOT recommended for treatment or prophylaxis of seasonal influenza in persons with lung diseases such as asthma or chronic obstructive pulmonary (lung) disease (COPD).

Of note, influenza viruses that are resistant to the other neuraminidase inhibitor drug oseltamivir (“Tamiflu”) are still susceptible to Zanamivir (“Relenza”). This fact could become important as increasing amounts of “Tamiflu” are used around the world due to high rates of resistance emerging now among influenza viruses (such as H3N2, H1N1, and H5N1) to the older anti-flu drugs “amantadine” and “rimantadine”.

Daniel R. Lucey, MD, MPH

Director, Center for Biologic Counterterrorism and Emerging Diseases

EROne Institutes, Washington Hospital Center, Washington, DC

Adjunct Professor of Microbiology and Immunology, Georgetown University

Website: www.BePast.org email: Daniel.R.Lucey@Medstar.net