ARCHIVED: Executive summary: The Management of the National Antiviral Stockpile: Options Report

Executive Summary

In June 2008, the Council of Deputy Ministers of Health directed the Public Health Network to make recommendations concerning the future of the National Antiviral Stockpile (NAS).  At the request of the Public Health Network, the Antiviral Supply Management Task Group was formed.   This report documents the research undertaken and the AVSMTG recommendations on the NAS with respect to management of the expiring antivirals, integration of the recent expert recommendations on the antiviral composition and best practices for ongoing maintenance of the stockpile.

In 2009/10, 28.4 million doses of oseltamivir – representing approximately half of the NAS – will expire. The task group considered all of the options, which they narrowed down to the following: purchase new stock, hold and stability test expiring stock, exercise the time limited Exchange Option for oseltamivir (get new stock for old stock) or a combination of the above. After considering all the potential advantages and disadvantages of all options, it recommended exchange all or a portion of expiring oseltamivir stock now and replace the rest later.

To integrate the recent expert recommendations and update the size of the stockpile to reflect the 2008 population, the AVSMTG recommended:

1. Purchase 5.7 million more doses of zanamivir (Relenza^R) to address the risk of resistance to oseltamivir.
2. Purchase 5.8 million amantadine capsules to be used in combination therapy for severe disease.
3. Meet paediatric needs by acquiring 7.2 million more doses of paediatric oseltamivir (Tamiflu^R) capsules by exchanging 3.1 million expiring adult oseltamivir capsules for paediatric capsules.