TAMIFLU® (oseltamivir phosphate) has been studied only in strains of influenza that were circulating at the time. The magnitude of effect of TAMIFLU in treating and preventing novel strains of influenza, such as those that may be involved in a pandemic, cannot be predicted.
How would a pandemic impact my organization?
Decline in travel and leisure activities17
As a pandemic spreads, international travel would dramatically decline as
people avoided flu "hotspots" and governments restricted travel. In all
likelihood, people would quarantine themselves and their families by
staying at home more. Nonessential activities requiring social contact
would be sharply curtailed, leading to significant declines in retail
trade. People would avoid public places, such as shopping malls, community
centers, places of worship, and public transit. Attendance at theaters,
sporting events, museums, and restaurants would decline.
Schools and business would suffer17
It seems likely that many schools would close, and even if they did not,
attendance would fall dramatically as parents kept their children at home.
In either event, large-scale school closings would lead to a spike in workplace
absences because parents would stay home to care for their children even if
they were not sick. The impact on businesses of all kinds due to employee
absenteeism would be dramatic.
Supply-side impact17
Lost Employee Productivity
Increase in absenteeism due to illness, caring
for sick, and social distancing policies; could reach 40%
during peaks
Risk that some companies do not have capacity to support increases in telecommuting
Disruption of Supply Chains
Disruption of transportation networks that limit ability to receive and distribute goods
Operations and Facilities Shutdown
Increase in absenteeism due to illness, caring for sick, and social distancing policies; could reach 40% during peaks
Inability to maintain operations because of shortages of staff, shortages of supplies, or a slowdown in servicing utilities
Closure of facilities due to implementation of policies to contain the pandemic (e.g., social distancing)
School closings would likely happen very early in a pandemic and could occur on short notice
Demand-side Impact17
Drop in Demand for Products and Services
Certain companies will see drops in demand for products and services
- Reduction in customer base due to illness
- Customers likely to avoid public shopping areas, restaurants, entertainment facilities, etc
- Potential decline in income and discretionary spending as businesses are forced to halt operations
Closure of facilities due to implementation of policies to contain the pandemic (e.g., social distancing)
FOOTNOTE
17. Congressional Budget Office. A potential influenza pandemic: possible macroeconomic effects
and policy issues. December 2005. Available at: http://www.cbo.gov/ftpdocs/69xx/doc6946/12-08-BirdFlu.pdf. Accessed April 13, 2006.
Indications
TAMIFLU is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients 1 year and older who have been symptomatic for no more than 2 days.
TAMIFLU is also indicated for the prophylaxis of influenza in patients 1 year and older.
TAMIFLU is not a substitute for early and annual vaccination as recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP).
Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.
Safety Information
There is no evidence for efficacy against any illness caused by agents other than influenza types A and B.
Treatment efficacy in subjects with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was observed between the treatment and placebo groups in this population.
No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization.
Efficacy of TAMIFLU has not been established in immunocompromised patients.
Safety and efficacy of repeated treatment or prophylaxis courses have not been studied.
Influenza can be associated with a variety of neurologic and behavioral symptoms, which can include events such as hallucinations, delirium and abnormal behavior, in some cases resulting in fatal outcomes. These events may occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease. There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these events has not been established. Patients with influenza should be closely monitored for signs of abnormal behavior. If neuropsychiatric symptoms occur, the risks and benefits of continuing treatment should be evaluated for each patient.
In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported with TAMIFLU.
The most common adverse events reported >1% of patients treated with TAMIFLU and more commonly than in patients treated with placebo are:
Treatment of adult and pediatric patients - nausea, vomiting.
Prophylaxis of adult and pediatric patients - nausea, vomiting, abdominal pain.
Vaccination is considered the first line of defense against influenza.
