Antiviral Medication Distribution

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Antiviral Medication Distribution

  1. 1. Texas Pandemic Influenza Regional Conference Antiviral Medication Distribution Texas Department of State Health Services (DSHS) And Texas Division of Emergency Management (DEM) August and September, 2009
  2. 2. Presentation Outline <ul><li>What is an antiviral medication? </li></ul><ul><li>Brief Overview of Clinical Guidelines </li></ul><ul><li>Differences between Antiviral Medication & Vaccine </li></ul><ul><li>Strategic National Stockpile Overview </li></ul><ul><li>State Stockpile </li></ul><ul><ul><li>Overview </li></ul></ul><ul><ul><li>Access </li></ul></ul><ul><ul><li>Distribution </li></ul></ul><ul><ul><li>Reporting </li></ul></ul><ul><li>Supply Chain Disruption </li></ul><ul><li>Key Points </li></ul><ul><li>Considerations </li></ul>Page
  3. 3. <ul><li>A medication that has activity against influenza viruses, including the novel H1N1 influenza virus </li></ul><ul><li>Can be used to treat or help prevent novel H1N1 influenza </li></ul><ul><li>Is only appropriate in specific circumstances </li></ul><ul><li>Requires a prescription from a healthcare provider </li></ul><ul><li>Is just one component of a comprehensive containment and treatment plan to help control novel H1N1 influenza </li></ul>Antiviral Medication What Is An Antiviral Medication? Page
  4. 4. <ul><li>Treatment </li></ul><ul><li>Must be used within 48 hours of onset of symptoms for maximum effectiveness </li></ul><ul><li>Should be targeted to high risk populations </li></ul><ul><ul><li>Pregnant women, children, adults with chronic diseases (such as asthma, COPD, and diabetes) </li></ul></ul><ul><ul><li>Patients hospitalized due to novel H1N1 influenza </li></ul></ul><ul><li>Healthcare providers should follow guidance from DSHS found at www.texasflu.org </li></ul><ul><li>Antiviral medications can sometimes be used for preventive treatment in limited situations </li></ul>Antiviral Medication Brief Overview of Clinical Guidelines Page
  5. 5. Antiviral Medication Differences between Antiviral Medication and Vaccine Page Antiviral Medication Vaccine Primarily used to treat influenza, specialized use for preventing influenza Used to prevent influenza Does not build immunity in your body Helps your body build its own immunity You are only protected from influenza while you are taking the medication if used for prevention Once your body develops immunity, you have lasting protection Finite amount of medication, not enough to serve everyone CDC plans to have enough for anyone who wants it
  6. 6. Q What is the Strategic National Stockpile? A The Strategic National Stockpile (SNS) is a federal government stockpile of medicine and medical supplies available to states for public health emergencies upon request by state officials <ul><li>For pandemic influenza response, Texas receives a finite amount of antiviral medications from the SNS. </li></ul><ul><li>The SNS includes two types of antiviral medications – Tamiflu and Relenza. </li></ul>Antiviral Medication Strategic National Stockpile Overview Page
  7. 7. Q What is the State Stockpile? A A stockpile of antiviral medication DSHS purchased from federal preparedness funds and state legislature funds & antiviral medication received as the Texas portion of the federal Strategic National Stockpile <ul><li>The state stockpile includes materials received from the SNS </li></ul><ul><li>The state stockpile has a finite amount of antiviral medications that need to be used strategically </li></ul><ul><li>The state stockpile includes two types of antiviral medications - Tamiflu and Relenza </li></ul>Antiviral Medication State Stockpile Overview Page
  8. 8. Q When will the State Stockpile Be Used? A <ul><li>There are three primary purposes for the state stockpile: </li></ul><ul><li>Individuals who cannot access medication through routine channels </li></ul><ul><li>Public health measure needed for outbreak control </li></ul><ul><li>Routine supply channels breakdown </li></ul>Antiviral Medication State Stockpile Overview Page
  9. 9. Healthcare provider determines if an antiviral is appropriate Healthcare provider writes prescription Pharmacist fills prescription Access to Antiviral Medications for Patients Routine Channel for Patients Antiviral Allocation and Distribution Routine Channels for Access to Medication for Patients Page
  10. 10. <ul><li>Uninsured and underinsured may not utilize routine channels due to cost </li></ul><ul><li>DSHS created a mechanism to serve these patients through the state stockpile where patients can access medication at low or no cost based on the patient’s need </li></ul><ul><li>This mechanism uses a pharmacy distribution network that includes: </li></ul><ul><ul><li>Retail chain and independent pharmacies </li></ul></ul><ul><ul><li>Community Health Center (CHC) / Federally Qualified Health Center (FQHC) pharmacies </li></ul></ul>Antiviral Allocation and Distribution Access to State Stock Medication for Patients Page
  11. 11. Healthcare provider determines antiviral is appropriate Healthcare provider writes prescription Health Care Provider refers patient to a pharmacy that has state stock Access to State Stock Antiviral Medications for Specific Patients Healthcare provider identifies state stock is needed Pharmacist fills prescription from state stock Antiviral Allocation and Distribution Access to State Stock Medication for Patients Page
  12. 12. Local Health Departments <ul><li>Local health departments addressing public health outbreak control can access the state stockpile if local supplies are nearing or at depletion. </li></ul><ul><li>The local health department should contact the health service region to make this request. </li></ul>Antiviral Medication Public Health Measures to Address Outbreak Control Page
  13. 13. Antiviral Allocation and Distribution Routine Supply Channel for Health Care Entities Access to Antiviral Medications for Health Care Entities Medication supply runs low Order from supplier Treat patients Routine Channel for Health Care Entities Page
  14. 14. If routine supply channels break down, the Health Service Region has a mechanism to provide supplies to health care entities. Access to Antiviral Medications for Health Care Entities Medication supply runs low Order from supplier Treat patients Routine Channel for Health Care Entities Antiviral Allocation and Distribution Routine Supply Channel for Health Care Entities Page
  15. 15. Chain Pharmacies Independent Pharmacies FQHCs / CHCs DSHS Local Health Departments Uninsured/ Underinsured Populations Healthcare Systems DSHS Health Service Region Antiviral Allocation and Distribution Distribution System for State Stock Antiviral Medication Page
  16. 16. <ul><li>DSHS will track state stock antiviral medication usage and inventory levels. </li></ul><ul><li>Entities receiving state stock of antiviral medications will be required to report individual usage data and inventory levels to DSHS on a regular basis through an electronic system. </li></ul>Antiviral Medication Reporting Page
  17. 17. Uninsured and Underinsured Outbreak Control Supply Disruption <ul><li>For individuals who are uninsured or underinsured, antiviral medications can be distributed from the state stockpile </li></ul><ul><li>Healthcare providers will have information about how to access the state stockpile for patients in need </li></ul><ul><li>When required, the state stockpile can be used for outbreak control when deemed a necessary public health measure by either the DSHS Health Service Region or local health department </li></ul><ul><li>Used to meet immediate health care entity needs to due to supplier disruption or unavailability </li></ul>Antiviral Medication State Stockpile Utilization Summary Page
  18. 18. Q A <ul><li>DSHS will review epidemiological information at that time </li></ul><ul><li>DSHS will revise treatment guidance if necessary to determine appropriate allocation of the remaining stockpile </li></ul>What happens if the supply chain is completely unavailable ? Antiviral Medication Complete Supply Chain Disruption Page
  19. 19. <ul><li>Antiviral medications are appropriate only in specific circumstances </li></ul><ul><li>There are a finite number of antiviral medications available </li></ul><ul><li>Healthcare providers determine appropriateness of antiviral medication for patients </li></ul><ul><li>Healthcare providers should make their decisions based on the guidance found at www.texasflu.org </li></ul><ul><li>Antiviral medications are not a substitute for vaccine </li></ul><ul><li>Seek seasonal influenza vaccine as soon as that vaccine is available </li></ul><ul><li>Antiviral medications are just one component for controlling a novel H1N1 influenza virus outbreak </li></ul><ul><li>Non-pharmaceutical interventions (hand washing, social distancing, staying home from work/school when ill) are key elements to reduce transmission </li></ul>Antiviral Medication Key Points Page
  20. 20. Page Antiviral Medication Considerations Department of State Health Services <ul><li>Manage state stock antiviral medication distribution (allocate, process orders, ship) </li></ul><ul><li>Coordinate with stakeholders (health care providers, pharmacy partners, etc.) regarding state stock antiviral medication distribution </li></ul><ul><li>Provide clinical treatment guidance at www.texasflu.org </li></ul><ul><li>Track and report state stock antiviral medication usage </li></ul>Local Communities <ul><li>Guidance is available at www.texasflu.org </li></ul><ul><li>Use non-pharmaceutical interventions (hand washing, staying home when sick, etc.) to reduce transmission </li></ul><ul><li>Ensure continuity of operations plans do not rely on long-term antiviral medication for healthcare workers and first responders </li></ul><ul><li>Entities who receive state stock antiviral medications report on usage of this medication </li></ul>

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