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Pandemic Planning Toolkit A resource to assist your organization in preparing for pandemic influenza

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.

 
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Order antivirals for your organization
Now that you have identified the Quantity of TAMIFLU needed, you will need to order TAMIFLU for your organization. You may place an order for TAMIFLU from a number of entities. (see table below).
 
TABLE 1. ENTITIES* THROUGH WHICH YOU MAY
ORDER TAMIFLU
Entity
Description
Pharmaceutical wholesalersa Buys product directly from manufacturers and resells to retail customers
Specialty distributors Buys product directly from manufacturers and resells to smaller groups of customers. Able to provide specialized services to its customer base
Pharmacy Benefit Managers (PBMs) Processes pharmaceutical claims for pharmacies and fulfills pharmaceutical prescription orders via mail-order service. Some PBMs will serve as a third party facilitator (i.e., Handle transactions from order processing to product distribution)
Corporate Healthcare Providers (CHPs) Offers on-site health services that deliver primary care, occupational health and wellness programs for corporate employees. Some CHPs will serve as a third party facilitator (i.e., Handle transactions from order processing to product distribution)
Clinics with a dispensing license Often can provide a broad range of primary and specialty medical care services for the local community. Clinic must be registered to dispense medicines
Physician's office with a dispensing license A local primary care physician that is registered to dispense medicines
*Entities include but are not limited to those presented here.

The following checklist of considerations and important questions to answer will help you to determine the right entity through which your organization should place an order for TAMIFLU. Please remember that TAMIFLU is a prescription medication, and so each person will need a prescription prior to receiving the drug.
 

red checkmark  Review capabilities for employee health care delivery.
Use the below questions to assist in your decision making.
  • Does your organization have an on-site clinic with the ability to dispense prescription drugs?
  • Does your organization have a relationship (e.g. employee wellness programs) with a local clinic or physician group?
  • Does your organization have sufficient storage capacity to house the quantity of TAMIFLU you are planning on ordering and also meets appropriate storage criteria? (See Step 3: How to Store TAMIFLU)
Enter your YES or NO response to each question here:
 
Q1
Q2
Q3
     
 
The table below will assist you in your decision-making based on your responses to the above questions:
 
Q1
Q2
Q3
Solution
NO NO NO Your organization should consider using a third party facilitator such as a Pharmacy Benefit Manager (PBM) or a Corporate Healthcare Provider (CHP).
NO NO YES
NO YES YES Your organization should consider ordering product through a clinic or physician's office.
YES NO NO Your organization should consider ordering product through a wholesaler or specialty distributor; however, you must first determine whether these entities can store product on your company's behalf.
NO YES NO Your organization should consider ordering product through a clinic or physician's office; however, you must first determine which of these entities can store product on your company's behalf. If the clinic or physician's office are unable to order or store product on your company's behalf, the organization can use a third party facilitator such as a Pharmacy Benefit Manager (PBM) or a Corporate Healthcare Provider (CHP).
YES YES NO Your organization should consider ordering product through a wholesaler, specialty distributor, clinic or physician's office; however, you must first determine which of these entities can store product on your company's behalf.
YES NO YES Your organization should consider ordering product through either a wholesaler or distributor.
YES YES YES Your organization should consider ordering product through a wholesaler, specialty distributor, clinic or physician's office.
 
NOTE: In every scenario, organizations looking for a single point of contact should consider a third party facilitator such as a Pharmacy Benefit Manager (PBM) or a Corporate Healthcare Provider (CHP).
 
red checkmark  Determine preference for TAMIFLU shipping
Decide if your organization wants to receive product as:
  • Single Shipment: May be best for smaller quantity orders or for an individual receiving location
  • Staggered Shipments: May be best for larger quantity orders or for multiple receiving locations
 
red checkmark  Discuss key issues with candidate entities
Identify a short list of candidate entities to contact and at a minimum discuss the following issues:
  • Order terms/price
  • Delivery schedule
  • Competitive bidding
 
aRoche only sells to authorized wholesalers and distributors.
 
For a list of organizations that can fill orders for TAMIFLU, please contact Roche:
Email
Voice: (888) 394-2838

 
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Guidelines
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Indications and Important Safety Information

 

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.

Please see TAMIFLU full Prescribing Information for additional safety information.

 

Roche