From the corner office of the law firm Ropes & Gray, stockpiling medication for swine flu to limit absenteeism among its workers must look like a no-brainer. But for public health officials, this practice raises the prospect that the drug Tamiflu will be used in cases where it really isn’t needed, increasing the risk of drug-resistant strains of the swine flu virus. Such stockpiles could also lead to shortages of the medication, although its maker, Roche, says supplies are ample.
The law firm is one of about 300 companies that have arranged for special supplies for its workers. According to Roche, some companies are leaving it to doctors to make the final decision on dispensing the medication. But under the Ropes & Gray plan, employees will be able to get a prescription for a supply of the drug while they are still healthy and then use it whenever they feel it’s needed.
Health officials are particularly concerned that employees or their family members will come down with a cold or a mild case of swine flu and pull the Tamiflu out of the medicine cabinet. Under the guidelines of the US Centers for Disease Control and Prevention, physicians should reserve Tamiflu for seriously ill patients or ones at risk of dangerous complications, such as pregnant women or patients with chronic infirmities.
Doctors have two weapons against swine flu: the vaccine to prevent it and anti-viral medications to reduce the duration and severity of symptoms in the most stricken patients. Doctors don’t want to see their most effective drug against flu weakened by indiscriminate use. While there has been very little resistance to Tamiflu among swine flu patients so far, that could change as cases mount up and more physicians prescribe the drug. To keep that from happening, the drug should go only to seriously ill patients who a doctor has determined meet the CDC guidelines for its use.
And Ropes & Gray should quit hoarding and have its employees await their doctors’ orders like most of the rest of the world.
