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Agency for Healthcare Research Quality

Public Health Preparedness

A substantial number of adults stockpiled drugs for the avian flu outbreak in 2005

During the fall of 2005, amidst media reports of a worldwide H5N1 influenza (bird flu) outbreak, a substantial number of adults stockpiled prescribed Tamiflu® (oseltamivir), reports a new study. Stockpilers were more often older and of white race. They more often reported greater worry about the flu, felt more vulnerable to getting infected, and expected that it would spread to the United States.

Researchers at the Center for Education and Research on Therapeutics (CERT) at the University of Pennsylvania School of Medicine identified 109 individuals who received prescriptions for the influenza medication oseltamivir from 45 providers. They examined medical records and supplemental questionnaires to determine drug usage patterns. They compared individuals who received oseltamivir prescriptions with those who did not receive oseltamivir prescriptions. The study period was between September 1, 2005, and December 31, 2005, when there was intense media coverage about avian flu outbreaks in certain regions.

The majority of oseltamivir prescriptions were written by internists (47.7 percent) and family medicine practitioners (39.4 percent). Only 33 percent of individuals received a prescription for an appropriate indication. Oseltamivir is appropriately prescribed within 12 to 48 hours of initial flu symptoms to be effective in alleviating duration and severity of symptoms. It is also used to prevent the flu among persons exposed to infected individuals. Among those getting inappropriate prescriptions, 15.1 percent specifically requested the drug for stockpiling. Another 24.7 percent requested it without giving a reason.

The study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS10399) to the University of Pennsylvania School of Medicine CERT. For more information on the CERTs program, please visit

See "Stockpiling drugs for an avian influenza outbreak: Examining the surge in oseltamivir prescriptions during heightened media coverage of the potential for a worldwide pandemic," by Leanne B. Gasink, M.D., M.S.C.E., Darren R. Linkin, M.D., M.S.C.E., Neil O. Fishman, M.D., and others, in the April 2009 Infection Control and Hospital Epidemiology 30(4), pp. 370-376.

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