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At least six states plan to buy smaller quantities of antiviral drugs than the federal government has offered them, a setback for part of the government's bird flu pandemic plan.
Comments from state officials who replied to USA TODAY queries highlight challenges facing the nation's pandemic-planning campaign, which includes stockpiling enough anti-virals to treat 25% of the population.
"It would be irresponsible to put all our eggs into one basket, for a drug that we don't know will work, against a pandemic that we don't know we'll have," said Arizona state epidemiologist David Engelthaler, in an e-mail.
Less than two weeks before a federal deadline for states to announce their plans, at least 16 say they're undecided how much Tamiflu and Relenza they'll buy. Thirteen others ? including California, the biggest state ? say they plan to buy their full allotments.
Bird flu has killed 132 people in 10 countries in Asia, the Middle East and Africa since 2003. The virus has not shown it can spread easily among humans, but there's fear that if it starts to, many people could die because humans have no immunity to the virus and there are no proven vaccines. Tamiflu and Relenza cut the severity of regular flu and may improve survival for bird flu victims, the World Health Organization says.
The federal government plans to buy 44 million antiviral treatment courses for the states this fiscal year and next, enough to cover 17% of their populations. It wants states to buy 31 million more courses, to reach 25%. A course is the amount needed to treat one person.
Even at a discount ? about $15 for Tamiflu, about a fifth of the Internet retail rate ? cost is a concern.
Arizona plans to spend $1 million for 70,000 courses. The state's full allotment of 585,780 courses would cost about $8 million, draining funds needed to prepare hospitals, Engelthaler says.
Colorado plans to buy 5,400 courses ? not the 477,470 allotted to it. Officials want more evidence the drugs work against bird flu before spending "precious state resources," says Chris Lindley, state emergency response chief.
Arizona and Nebraska are trying to get local entities to pay for more anti-virals. So is Oklahoma, which now plans to buy 9% of its allotment but may increase it. Montana and North Dakota also don't plan to buy full allotments. Other states didn't respond.
The Aug. 1 deadline will help drugmakers plan, but states can change orders through Dec. 31. Businesses cannot buy the drugs at the federal discount, says the Department of Health and Human Services.
Roche makes Tamiflu, which will fill the bulk of stockpiles. GlaxoSmithKline makes Relenza. States must use the drugs only in a pandemic, not for regular flu, HHS says.
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