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 Collaboration.
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 them.
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 money''.
''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 thing.''
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.
