The method and timing of TAMIFLU distribution to employees is specific to
each organization's pandemic plan. Consider the merits/challenges of
various options before making a final determination. Similar to the
employee consultation process, the choices made in prior steps may
influence your distribution plan. Answering these questions will help
guide your decisions regarding TAMIFLU distribution.
How will the organization use TAMIFLU?
The company should define the role of TAMIFLU during a pandemic. Here are the three most likely roles:
Keep a cache of TAMIFLU for treatment of on-site employees when they appear to have flu symptoms or for prevention when on-site employees may have been exposed to someone with flu symptoms
Distribute TAMIFLU in advance to employees at home so they can use it as needed in the event of a pandemic
Distribute TAMIFLU in advance to employees at their homes so that they can use it as needed in the event of a pandemic AND maintain a cache of TAMIFLU for on-site employees
Should distribution to employees be centralized or direct? Centralized distribution
Product can be dispensed to employees from a central distribution point (e.g. On-site clinic) during a pandemic or at any other predetermined trigger point.
May be an optimal distribution strategy if ONLY on-site employees will receive TAMIFLU
Issues to consider
Number of eligible employees: Large numbers of employees eligible to receive TAMIFLU could make dispensing logistically impractical in a time of crisis.
Number of sites: Organizations with multiple sites will require clinics & staff at all sites during a pandemic
Storage of Product: If product is stored at an off-site location it may complicate distribution logistics
Security: Organizations may require increased security
Infection Control: Centralized distribution may increase the risk of transmitting infection
Access: Gaining access to the corporate campus or office building may be challenging during a pandemic
Direct distribution to employees
TAMIFLU can be shipped directly to an employee at their home to ensure that they have product available during a pandemic. The organization can coordinate the distribution of TAMIFLU at a predetermined pandemic event phase with the assistance of a distribution partner.
May be an optimal distribution strategy for organizations with large numbers of employees, a distributed workforce or organizations that do not have on-site clinical services or storage capacity available..
Issues to consider
Lost or Damaged Product: Employees that receive TAMIFLU in advance may be at a greater risk of misplacing or damaging the product.
Inappropriate Usage: Employees that receive TAMIFLU in advance may be at a greater risk for misuse of TAMIFLU. However, with appropriate education, resources and ensuring employees contact a health care professional prior to administration, the risk can be sufficiently mitigated.
Remember that federal law requires each employee to obtain a valid prescription before receiving the drug.
Who will help your organization with distribution?
Identify a distribution partner
Prescription Benefit Managers
Pharmaceutical Wholesalers
Specialty Distributors
When will you distribute TAMIFLU to employees?
The decision as to when to distribute is specific to your company's pandemic plan. Consider the following possible options:
Immediately upon receipt of the organization's TAMIFLU order
When public health officials declare that a specific phase of the pandemic has been reached (Please refer to www.who.org for the current pandemic phase)
When certain event-triggers are met in accordance with your organization's pandemic plan.
TAMIFLU has not been shown to be effective against any illness other than that caused by influenza types A and B. Efficacy of treatment in patients with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was seen 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 courses of TAMIFLU for treatment or prevention have not been studied. In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported.
There have been postmarketing reports (mostly from Japan) of self-injury and delirium with the use of TAMIFLU in patients with influenza. The reports were primarily among children. The relative contribution of the drug to these events is not known. Patients with influenza should be closely monitored for signs of abnormal behavior throughout the treatment period. In treatment studies in adult patients, the most frequently reported adverse events (incidence ≥ 1%) were nausea and vomiting. Other events reported numerically more frequently in patients taking TAMIFLU compared with placebo were bronchitis, insomnia and vertigo. In treatment studies in patients 1 to 12 years old, the most frequently reported adverse event (incidence ≥ 1%) was vomiting (15%). Other events reported more frequently in patients taking TAMIFLU compared with placebo included abdominal pain (5% vs 4%), nosebleed (3% vs 3%), ear disorder (2% vs 1%) and pinkeye (1% vs < 1%).
In prophylaxis studies in adult patients, adverse events were similar to those seen in the treatment studies. Events reported more frequently in patients taking TAMIFLU compared with placebo (incidence ≥ 1%) were nausea (7% vs 3%), vomiting (2% vs 1%), diarrhea (3% vs 2%), abdominal pain (2% vs 1%), dizziness (1% vs 1%), headache (18% vs 18%) and insomnia (1% vs 1%). In a household prevention trial that included patients 1 to 12 years old, adverse events were similar to those observed in pediatric treatment studies, with GI events being the most common.
The concurrent use of TAMIFLU and live attenuated influenza vaccine (LAIV) intranasal has not been evaluated. However, due to the possibility for interference between these products, LAIV should not be given within 2 weeks before or 48 hours after taking TAMIFLU, unless it is deemed appropriate by your doctor. Trivalent inactivated influenza vaccine can be administered at any time relative to use of TAMIFLU.
Tell-A-Colleague
How will the organization use TAMIFLU?
