Crisis Planning: Flu Preparedness

China reported at the end of January that the avian flu (H5N1) claimed another victim, marking the fifth death from the virus in China this year. According to the World Health Organization, since 2003 about 400 cases of the virus have been reported, 252 of them resulting in death. Scientists and health officials warn that although the bird flu currently cannot be passed between people, the possibility of the virus mutating into a passable infection between humans is plausible. In light of this-and for the general threat the flu causes, hospitalizing some 200,000 people per year-it is critical for the pharmaceutical industry to be prepared for a potential flu pandemic by strengthening corporate infrastructure and ensuring a continuous information flow to both insurers and patients.

As we enter a new phase of US political leadership, all American citizens-including corporate citizens-are increasingly being called upon to play a role in the country’s short- and long-term economic stability, and overall health and resiliency. For its part, the pharma industry has experience in developing important multi-sector initiatives and once again has the opportunity to demonstrate solid corporate leadership.

For example, in 2007, the Pharmaceutical Research and Manufacturers of America (PhRMA) announced the launch of a disaster response initiative called Rx Response, which was designed to support continued delivery of critical medicines during a severe public health emergency, such as in the aftermath of a hurricane.

I had the privilege of working with industry colleagues on the development of the program, which is an example of how a wide range of stakeholders can come together in partnership to prepare for a potential crisis. Rx Response is unprecedented in how it engaged not only all industry partners involved in delivering medications, but also non-commercial sectors, such as the US government and community organizations like the American Red Cross. More information is available at www.rxresponse.org.

The Rx Response model is based on the premise that collaboration -among all sectors of society as well as within each sector-is key to effective emergency preparedness and response.

The completion of the program represents a significant milestone for our industry and is a sign of how far we’ve come since Hurricane Katrina, when we had very little formal guidance or plans in place. We’re now much more prepared to sustain the supply chain of medicine in areas hit by such a disaster.

Now, we should look forward to other types of emergency situations, where our delivery systems and supply chains may still be vulnerable. For example, we could apply similar principles to address the threat of an influenza pandemic, which experts say remains very real, and which poses a unique set of challenges for the industry.

The Groundwork is Laid For a Consolidated Approach
The good news is that a strong foundation has been established by the federal government, which has demonstrated leadership in preparing the country for a pandemic, particularly in engaging the private sector.

Dozens of helpful checklists and planning documents have been developed to guide all sectors of society through the process, and many cite the specific importance of critical-sector planning, including the healthcare industry.

Referring to the role of businesses in pandemic preparedness, Mike Leavitt, the outgoing secretary of the US Department of Health and Human Services (HHS), has noted, “Planning by business leaders will be critical to protecting the health of employees, limiting the negative economic impact, and ensuring the continued delivery of essential services like food, medicine, and power.”

There are special considerations for the pharma industry-failure to operate during a flu pandemic will be deemed unacceptable by the public, who are dependent on our products and services to get through daily life. Without food on their tables, money in their wallets, heat in their homes, and, yes, prescriptions in their medicine chests, Americans won’t wait long before voicing their frustration with corporate America for failing to do its part to prepare-particularly when there has been so much advance warning.

And, we do have an edge. Pharma companies obviously know how to manufacture, distribute, store, and administer drugs, and we understand the regulatory and legal issues involved. Many of us have already contributed to pandemic preparedness on an individual basis. Our vaccine manufacturers have been working with the federal government to research and develop new technologies and improve the delivery infrastructure. Roche has invested significantly to help make our antiviral medication Tamiflu available and accessible where and when it’s needed, including establishment of a full supply chain on US soil. Many of us have plans in place to help ensure we can continue to produce life-saving medicines during a pandemic.

We are at different levels of readiness, and there are steps we can take to optimize our preparedness as an industry and maximize our ability to deliver medications to patients. Working together, there are several areas we can improve and build:

Take the lead to work with insurers: A collaborative and innovative effort is needed to design and implement coverage solutions for a pandemic situation. We need to determine how claims will be processed, how providers will be paid, and how the administrative process will be maintained. How will patients be covered for drugs or medical supplies needed during a pandemic?

Develop patient communications

: Work with providers to communicate to patients, so they understand what measures are in place and how they can access their medication during a pandemic. For example, how will patients fill their prescriptions if they can’t obtain them at the pharmacy or can't reach physicians for prescription renewals? How will mail order be affected? Who can they contact for help and how? The best-laid plans won’t work unless people know about them -patient awareness itself is a link in the supply chain.

Create best practices for use of employee medical interventions: Pharma companies can tap into their distinct expertise and knowledge to creating and sharing best practices, in order to assist others in decision-making and planning.  

For example, in December, HHS issued guidance encouraging US businesses to consider stockpiling antiviral medications as part of their planning. The guidance notes that critical infrastructure employers, including those in the pharmaceutical industry, “should strongly consider providing antiviral prophylaxis [preventive use] for the small number of employees who are critical to essential operations” as part of comprehensive pandemic preparedness planning.

We know that a number of pharma companies have stockpiled antivirals for their employees both in the US and abroad. They have taken different approaches, both in numbers of employees covered and the type of coverage they are employing. How different pharma companies have interpreted the guidance could be enormously helpful to colleagues in our industry as well as other sectors.

Coordinate supply chain continuity plans with business partners: We need to engage and coordinate with all companies involved in the manufacturing and distribution cycle of pharmaceutical products, in order to get through sustained periods of limited production. Wholesalers, distributors and retailers must play a role in determining contract adjustments for different scenarios, establishment of priorities, and communications mechanisms to address developing needs. Again, some of us have been taking steps individually-Roche hosted more than 100 of its business partners at a seminar in 2007-but, as an industry we can do more.

Create employee volunteer programs: Volunteers will be needed to perform a number of services during a pandemic. Our industry employs large numbers of people with specialized knowledge and expertise, who may be willing to play a role in helping their communities respond to a pandemic situation. An industry task force could outline opportunities to work with community outreach programs.

Public health experts agree the pandemic flu is still a threat. The US government has taken a number of unprecedented steps to help prepare the country, encouraging planning by all sectors of society. As HHS Secretary Leavitt put it, “The Federal government cannot mount an effective response to the threats that we face as a nation without partners at every level of government and throughout society.”

We all hope a pandemic flu never comes, but if the predictions are right and a pandemic hits the United States, the case study on the pharma industry can be a good one. We can act as good corporate citizens by contributing to the country’s overall preparedness and response. It makes sense for people and for our business.

A comprehensive guide to corporate pandemic planning is accessible at www.PandemicToolkit.com.