GSK and Roche: UK government orders flu drugs

Published:03-February-2009

By Datamonitor staff writer

The UK government has bought enough of Roche's and GlaxoSmithKline's antivirals to treat half of the country's population, in an attempt to fortify itself in case of an influenza pandemic. However, this may not be the best strategy for preventing high mortality in the event of a crisis.

The UK government has ordered millions of doses of influenza treatments Relenza and Tamiflu.

The UK Department of Health has doubled its stockpile of antiviral influenza (flu) drugs, making it the second European nation (after France) to have enough medicine to treat 50% of its citizens if a pandemic strikes. The government ordered 10.6 million courses of Relenza from GlaxoSmithKline (GSK) and 7.6 million of Tamiflu from Roche, which puts the country's total stockpile at 33.5 million doses of antivirals.

While precise financial terms are confidential, the government's order will certainly be a welcome boost for both pharmaceutical companies, particularly GSK: this is the first time that the UK has added Relenza to its antiviral stockpile, having previously relied solely on Roche's Tamiflu. The decision to also order GSK's offering was based on the European Medicines Agency's recommendation that governments should diversify and not rely on just one treatment, due to increasing reports of the influenza virus's resistance to neuraminidase inhibitors.

Nevertheless, the question as to whether antivirals are the best way to protect citizens from an influenza pandemic remains unanswered. A significant issue is that the stockpiled drugs need to be administered within 48 hours of infection in order to be most effective. In practice, this means that a sufficient supply to treat half of the population does not automatically translate into speedy and directed distribution. Furthermore, the antiviral drugs have a limited shelf life. From the details disclosed by the UK government, it is unclear if the stockpile is managed, i.e. that drugs approaching their use-by date will automatically be replaced by the manufacturer, or if it was a one-off purchase.

An alternative approach could be to invest in influenza vaccines. Novartis has already demonstrated an impressive degree of cross-protection against various avian influenza strains in people re-immunized with MF59-adjuvant containing flu vaccines. Another upside is the absence of resistance issues. However, vaccines have their own set of limitations: the infrastructure of manufacturing, storage and distribution has to be reliably in place, and mass vaccination on a nationwide scale is equally untested.

In practice, a joint approach to preventing and treating an avian influenza pandemic would make the most sense: each approach has its strong points. A stockpile of neuraminidase inhibitors will buy valuable time, while vaccines provide prophylactic protection and can stop an outbreak in its tracks.