Heavy prescription rates leading to shortages of 'flu drug Tamiflu
Estonia could be facing a shortage of the anti-influenza drug Tamiflu, thanks to heavy prescribing, the leader of the family doctors' association has warned.
Tamiflu, also known as oseltamivir, is used according to World Health Organization (WHO) recommendations in cases of severe or progressive influenza. Preferably within 48 hours, but if necessary, up to five days after the onset of symptoms.
Alina Terep, board member of the family doctors' association (Perearstide selts), recommended limiting issuing Tamiflu to risk groups as a result.
"If the incidence of influenza remains at the same level as it was in December and doctors continue to prescribe this medicine as freely, a drug shortage can be expected. The first serious step to prevent such a shortage would in fact be to restrict prescribing the medicine. Meaning it should be prescribed only to patients in risk groups, both for prophylaxis and for treatment," Terep told ERR.
In accordance with the recommendations of WHO and other treatment guidelines, the drug is not meant for a healthy child or adult in any case, Terep noted.
"I am referring to those who do not have serious comorbidity conditions, such as asthma, chronic obstructive pulmonary disease, kidney failure, and so on. In other words, for otherwise healthy people, Tamiflu does not provide much benefit, neither for prophylaxis nor does it significantly shorten the course of true influenza," she said.
Since the treatment is virus-specific, a lab-confirmed diagnosis is required before use. As a result, family doctors prescribe it only after a lab or home test. It remains unclear whether prescriptions can be obtained via the family doctor advice line.
"At present, there is no Estonia-specific treatment guideline, likely because WHO recommendations are comprehensive. The approach to issuing prescriptions may vary between doctors," Terep said.
Treatment guidelines are drafted and updated by the society, along with the Estonian Society for Infectious Diseases (Eesti Infektsioonhaiguste Selts) and the Health Insurance Fund (Haigekassa).
The state Health Board (Terviseamet) has said it cannot issue treatment recommendations or decide prescriptions. Doctors assess each patient's illness and determine treatment, including oseltamivir.
Flu rates were deemed "epidemic" in Estonia in December, with around 2,000 new cases have reported in the second-to-last week of the year alone.
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Editor: Andrew Whyte, Mait Ots
