By Jeremy Manier,Chicago Tribune

CHICAGO – In a bid to stop panic buying of flu medications based on premature fears about a pandemic, drug maker Roche Holding AG has temporarily halted distribution of Tamiflu in the United States, citing unusually large purchases as an indication some buyers are hoarding the drug.

Most public-health experts have urged consumers not to build private stores of Tamiflu, a prescription drug that can reduce the severity of ordinary flu and may help against the avian flu strain, which some experts fear could spur a pandemic. Unwarranted use of Tamiflu could help flu strains mutate into forms that are resistant to the drug, among other problems.

Doctors and pharmacists said they have seen signs for weeks that consumers and pharmacy chains were buying up the anti-flu drug, which is not a vaccine but a medication that relieves some flu symptoms.

Roche plans to resume Tamiflu shipments within the next few months, once ordinary flu outbreaks begin. Company officials said they recently observed more large purchases at the wholesale level, which they feared would deplete Roche’s supply available for the flu season.

“These purchases have been for large enough quantities that we’re concerned about hoarding of the drug in general, whether for seasonal flu or a possible pandemic,” said Darien Wilson, a spokeswoman for Switzerland-based Roche’s U.S. offices in Nutley, N.J.

Wilson said the large purchases have been by private companies, which Roche has not named. Doctors said there also has been an increase in demand for the drug among patients.

Public-health researchers and organizations have said widespread premature use of Tamiflu could help strains of flu virus gain resistance, much as improper use of antibiotics can make those drugs ineffective against bacteria.

In addition, the United States and other nations are planning to stockpile Tamiflu in case of a flu pandemic. Private hoarding could divert the drug away from people who need it most.

Those are convincing arguments to Dr. John Flaherty, associate chief of the infectious disease department at Northwestern University, who said he has received two dozen direct or indirect requests for Tamiflu in the last month or so. He said he has refused to prescribe the drug because there has been no outbreak of flu yet this season.

In the event of a pandemic, “from a strategic standpoint the smarter plan would be for government to stockpile this and target its use around identified cases,” Flaherty said.

Yet there has been no official guidance on Tamiflu, from the U.S. Department of Health and Human Services or from Roche, on whether citizens should buy the drug in preparation for a pandemic that may never come.

“Our position has always been that’s a decision you need to make with your physician,” said Wilson. Patients should never buy the drug through an Internet pharmacy without seeing a doctor, she said.

Tamiflu, with a shelf life estimated at five years, is not the only drug that could work against an avian flu pandemic. Studies indicate that Relenza, made by GlaxoSmithKline, may also offer some protection.

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Flaherty said he understands the concerns of patients who have read that Tamiflu might be one of the few defenses against a pandemic strain. Humans have no natural immunity to the avian flu circulating among birds in Asia and Europe – a vulnerability that could make the strain deadlier than ordinary flu.

The avian flu so far has not spread from human to human, though many experts have said it’s likely that will happen, perhaps years from now.

“It’s hard to say convincingly to someone, No, you shouldn’t go get some (Tamiflu) and stock up,” Flaherty said. “I’m sort of tempted myself.”

The American Academy of Pediatrics is preparing a statement urging doctors not to prescribe the drug for patients’ personal stockpiles, according to The Associated Press. The American Medical Association already has come out against stockpiling Tamiflu.

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Warren Winston, a pharmacist from Pittsfield, Ill., said he saw evidence of increased Tamiflu purchases by pharmacy chains in the last month while he was filling in at numerous downstate Illinois drugstores that were short on pharmacists.

“Based on what I’ve seen, the chains have been stocking up on Tamiflu,” said Winston, who is organizing avian-flu preparedness for the Illinois Pharmacists Association.

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No one can be sure that Tamiflu will work against a pandemic flu strain, though it has appeared to be effective for animals infected with the H5N1 variant that has spread among birds in Asia and Europe. That strain has killed 62 people in Southeast Asia, most of whom had very close contact with infected birds.

If the virus mutates so that it can spread easily among people, there’s no guarantee Tamiflu will still be effective, experts said.

The lack of a unified message on whether patients should seek Tamiflu on their own may be because the United States is still working on a comprehensive national response plan for the possibility of a flu pandemic. A final draft is expected soon.

In a statement Thursday, Senate Majority Leader Bill Frist, R-Tenn., said Roche’s actions to suspend Tamiflu shipments “underscore the critical need for a comprehensive, coordinated and aggressive pandemic influenza-preparedness plan.”

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(Staff reporter Bruce Japsen contributed to this report.)

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(c) 2005, Chicago Tribune.

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AP-NY-10-27-05 1949EDT

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