Public Views on Alternative Methods for Antiviral Distribution and Dispensing During an Influenza Pandemic

Abstract

Antiviral drugs could play a crucial role in minimizing the impact of a severe influenza pandemic. The Centers for Disease Control and Prevention, in coordination with state health departments, has plans to distribute antiviral drugs from federal stockpiles in the case of a pandemic. These plans are currently under review and include evaluation of the benefits of pharmaceutical supply chain distribution and dispensing of antivirals through community pharmacies. While research has shown wide acceptance among pharmacists, public acceptability of going to community pharmacies for stockpiled antivirals in an influenza pandemic is unknown. This study uses the first nationally representative survey of US adults to assess public views of this approach. Overall, there was widespread support for the proposed system, and a majority predicted they would be likely to get antivirals in pharmacies compared to public health clinics. However, preference for using pharmacies dropped substantially when even modest fees were introduced. Those without insurance were less likely to say they would get antivirals and, along with those in lower income groups, were more likely than others to use public health clinics at all cost points. Further, sizable proportions expressed concerns about side effects, a desire to wait until symptoms got worse, and hesitation about using drugs beyond the labeled expiration dates. These factors could decrease uptake of antivirals from any source. Findings should be interpreted as broad acceptability of the concept, encouragement for next steps in system design, and a guide to potential barriers to be addressed.

In a pandemic, CDC plans to distribute antiviral drugs from federal stockpiles through public health clinics and community pharmacies. Research has shown wide acceptance among pharmacists, but will the public go to community pharmacies for antivirals? This study uses the first nationally representative survey of US adults to assess public views of this approach. Overall, there was widespread support for the proposed system, and a majority predicted they would be likely to get antivirals in pharmacies compared to public health clinics. But preference for using pharmacies dropped when even modest fees were introduced.