Millions of dollars
spent hoarding Tamiflu are probably a waste of money that
could fund other health services, University of Otago
biostatistician Prof Peter Herbison says.
Governments around the world have been called on to reassess
the stockpiling of antiviral drugs after the release this
week of an authoritative review from the Cochrane
Using previously secret drug-trial data, reviewers found no
evidence for a reduction in hospital admissions,
complications or spread of influenza. While Tamiflu and
Relenza gave 12 hours' symptom relief, reviewers concluded
this was not sufficient to support policies to stockpile
Citing conflicting evidence about the drugs' efficacy, the
Ministry of Health said this week it would maintain its $46
million antiviral stockpile, which includes about $32 million
worth of Tamiflu.
''I do tend to think that it is a waste of time spending
money on Tamiflu,'' Prof Herbison said.
He acknowledged possible benefits from symptom relief by
reducing burden on the health system, but did not believe
they warranted the stockpile. He suggested one option might
be to reduce the size of the stockpile.
Much of it was to be used to enable health and other key
workers to stay on the job during a flu pandemic, and for
that purpose it ''clearly seems to be a waste of time and
''Uncontaminated'' by conflicts of interest, the Cochrane
Collaboration was independent and highly respected, he said.
He believed it was sometimes difficult for health authorities
to admit they might be mistaken, even though medical science
constantly evolved. ''People do not like being proven wrong
on something they're committed to,'' Prof Herbison said.
University of Otago Faculty of Medicine dean Prof Peter
Crampton, who is also a public health physician, said there
was potentially ''significant opportunity cost'' in the
millions of dollars worth of stockpiled drugs.
He said he had not studied the review, and thus could not
form a personal view yet.
''I expect that our colleagues in the Ministry of Health will
be looking at the evidence very closely and working with
international authorities, including the World Health
Organisation, with a view to deciding whether they need to
revise their current policies.''
He believed the ministry was right in ''not reacting
instantly'' but expected it to look further at the findings
of a ''highly credible independent research voice''.
''There is clearly a significant opportunity cost here. As
with all health interventions, we need to weigh the cost and
the benefit, and if there's a better alternative use for
those resources, we should be using them on the better
In a statement, drug company Roche said it fundamentally
disagreed with the Cochrane Collaboration review findings.
''We firmly stand by the quality and integrity of our data,
reflected in decisions reached by 100 regulators across the
world and subsequent real-world evidence demonstrating that
Tamiflu is an effective medicine in the treatment and
prevention of influenza.
''Other trials and real-world data from seasonal influenza
and the 2009-10 flu pandemic have also shown that Tamiflu is
effective in reducing the severity and duration of symptoms
in those infected with flu.''
The Otago Daily Times asked the Ministry of Health for the
total cost, over multiple years, of stockpiling antiviral
drugs, such as Tamiflu, that need to be replaced when they
expire. The request would be considered under the Official
Information Act, a ministry spokesman said.