News From Terre Haute, Indiana

January 12, 2013

Children’s Tamiflu in short supply

By Arthur Foulkes and Howard Geninger
The Tribune-Star

TERRE HAUTE — Liquid Tamiflu, given to children who have the flu to slow or stop symptoms, is in short supply in the Wabash Valley but an adult capsule version of the of the drug is readily available in many pharmacies.

“There are intermittent shortages of the liquid version of Tamiflu, but not the capsule version, due to the supplier's challenges to meet the current demand,” said Mike DeAngelis, director of public relations for CVS Pharmacies, in an email to the Tribune-Star.

However, the adult capsules can be converted into a liquid. Roxanne Ling, pharmacist for UAP Clinic in Terre Haute, said information is “readily available in multiple sources” for a pharmacist to use a capsule, mix in water and add a syrup agent to get a liquid suspension that can be used for children.

“We may have some locations that are currently experiencing shortages in supply of [children’s Tamiflu], however our pharmacies are able to compound as needed to continue filling prescriptions for the liquid Tamiflu to meet the needs of patients during this flu season,” said Mai Lee Ua, a spokeswoman for Walgreen Co.

Two locally-owned pharmacies confirmed adult Tamiflu is available at their shops, but agreed the children’s version is harder to find.

“[Manufacturers] are raising the price on [adult Tamiflu] because of the demand, but I haven’t had any delayed orders,” said Becky Golden, a pharmacist for JR Pharmacy in Terre Haute. The children’s version of the drug in that pharmacy is currently on “back order,” she said.

A 10-day supply of Tamiflu currently costs about $118, Golden said. However, patients with insurance usually only pay a portion of that, she said.

The JR Pharmacy at Southland Plaza keeps 10 boxes of adult Tamiflu on the shelf each day, Golden said. The pharmacy orders replacement boxes as soon as one is dispensed, she said.

Tamiflu is used to treat people who have already been exposed to the flu virus. It must be taken within two days of the onset of symptoms, Golden said. It can also be taken to minimize flu symptoms by people in close contact with those who have the flu, she said.

“We have some on hand and we really haven’t seen much of a run on it,” said a representative of another Wabash Valley pharmacy who did not want to be identified. That pharmacy, which is outside of Vigo County, however, reported one customer driving from Terre Haute to purchase adult Tamiflu.

Two of the largest providers of flu vaccines in the United States are reporting shortages of flu treatments and vaccines, according to Reuters.

Sanofi SA said Thursday that four of its six formulations for the flu vaccine Fluzone are sold out. Rochhe Holding AG, which makes Tamiflu, reported a shortage of the drug’s liquid form late Wednesday.

Ling said UAP’s drug wholesaler, Cardinal Health, does not have a shortage of Tamiflu. However, it is out of Fluzone.

“We found out before Thanksgiving that Fluzone was not availble. However, we still had plenty in stock and we still have every formulation available other than the regular, which is for ages 3 and above. That is where we are experiencing some problems, but we do some alternatives,” Ling said.

Ling said the alternatives are FluMist, which can be used for anyone from 2 to 49 years of age and  a Fluzone High-Dose, used for people 65 and above. “We also still have the pediactric presentation of Fluzone which is for six months to 35 months,” Ling said.

“What we have had to do is to scramble for a regular flu vaccine that does not fit into any of those categories. The only product that we currently have been able to find is Afluria,” Ling said, adding it is to be used for people ages 9 and above.

Afluria is manufactured by CSL Biotherapies.

The Centers for Disease Control and Prevention last week reported that 41 states are experiencing “widespread geographic influezna activity,” up from the previous week. The CDC reported the proportion of people seeing a physician for influenza-like illness is above the national baseline for the fourth consecutive week, climbing sharply from 2.8 percent to 5.6 percent.

The CDC reports 29 states, including Indiana, as well as New York City, are reporting high flu activity. Overall, 41 states are now reporting influenza activity. Since Oct. 1, 2012, the CDC reports an increase of 735 hospitalizations weekly for laboratory-confirmed influenza-associated hospitalizations. That translates to a rate of 8.1 flu-associated hospitalizations per 100,000 people in the United States, according to the CDC.

So far, 18 influenza-associated pediatric deaths have been reported to the CDC in the 2012-2013 flu season.

Reporter Arthur Foulkes can be reached at (812) 231-4232 or Reporter Howard Greninger can be contacted at (812) 231-4204 or