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Mass. expands stock of flu drugs

Federal funds used to prepare for fall strains

By Stephen Smith
Globe Staff / July 16, 2009
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Massachusetts will have enough flu medication in its emergency stockpile to treat nearly 350,000 feverish, coughing patients by the time the fall influenza season arrives - an autumn that could deliver a potent and lethal brew of flu strains.

Authorities at the Department of Public Health decided in recent weeks to redirect $2.5 million in federal emergency preparation money toward bolstering the state’s cache of flu treatments, which is kept in reserve in case supplies at pharmacies, hospitals, and clinics run dangerously low.

The springtime arrival of swine flu - and its rapid spread around the globe - has fostered fears among disease trackers that the typical autumn and winter battle with the flu could turn into something epic later this year. They are steeling themselves for the potential that swine flu, known scientifically as H1N1, could reemerge with newfound vengeance at the same time the seasonal flu lands with its calling card of aches and chills.

“The flu is unpredictable in any season, and H1N1 is certainly unpredictable,’’ said Mary Clark, director of the Emergency Preparedness Bureau at the state health agency. “So we wanted to make sure we made additional purchases so that we are well-prepared for things that may happen in the fall.’’

After a round of emergency shipments during the height of the swine flu scare, the state still had enough courses of drugs called Tamiflu and Relenza to treat 203,000 patients. But health authorities decided that wasn’t sufficient, so they took the federal cash and purchased medication for an additional 141,500 patients.

They decided, in essence, to hedge their bets by dividing their order between the two flu drugs, a decision that reflects concerns that the swine flu strain may acquire the ability to outwit one of the medications. There are already hints that has begun to happen: Disease specialists in Denmark, Hong Kong, and Japan have detected isolated cases of swine flu virus that can’t be treated by Tamiflu. Still, specialists said there’s no evidence that H1N1 is becoming widely resistant to the medication.

The new supply of medication being delivered to the state - authorities expect all of it to be in warehouses by early August - includes Tamiflu pills for 70,000 patients, Relenza inhaler discs for 59,000 patients, and a powder form of Tamiflu for 12,500 children.

Dr. Mario Motta, president of the Massachusetts Medical Society, described the state’s decision to split its order as “a wise move.’’ And he said there was little doubt the state needed to expand its reserves, especially given that World Health Organization authorities this week said a vaccine against swine flu probably won’t be ready till late this year.

“Like anything else in life, you try to spend money wisely,’’ said Motta, a Salem cardiologist. “If a little bit of money prevents an economic catastrophe, let alone helps people who are ill, it’s money well spent.’’

The leader of the state’s professional organization for public health workers agreed - but only to a point.

“I think there’s a more important question,’’ said Valerie Bassett, executive director of the Massachusetts Public Health Association, noting that the economic swoon has caused local health boards in Massachusetts, as well as the state Department of Public Health, to lay off dozens of workers. “Do we have the public health professionals in place, and will we truly be prepared?’’

The appearance of swine flu in late April, at a time when the seasonal strain usually subsides, exposed gaps in the supply chain that delivers medication, masks, and testing swabs to hospitals and doctors’ offices. Since then, medical centers have restocked and reformulated their blueprints for coping with a deadly flu epidemic.

“People feel that the practice we had over the last several months has been good for us,’’ said Patricia Noga, senior director of clinical affairs at the Massachusetts Hospital Association. “But we really don’t know what we’re going to be faced with in the fall. We’re looking at all our patterns and trying to predict what may happen, but we’re just not sure.’’

Stephen Smith can be reached at stsmith@globe.com.