Employers should consider stockpiling antiviral medications to dispense to front-line health care workers and other critical employees, according to federal government guidance. The medications could be administered during an influenza pandemic before key workers get sick.
The U.S. Department of Health and Human Services has published guidelines (Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic) to help employers determine if they should stock antivirals, how those medications should be administered and to whom.
Federal, state and local governments have plans to protect the public during an outbreak, but “employers also will play a key role in protecting employees’ health and safety, thereby limiting pandemic impacts on health, the economy and society,” the guidance states.
Employers that provide front-line health care and other emergency services should plan to protect their employees who will be exposed to ill people during a pandemic, the guidance states. Businesses that provide goods or services essential to community health, safety or well-being need to be ready to continue operations during a pandemic. And some companies will need to make sure critical workers stay on the job for business continuity. Part of their readiness plans—in addition to practicing good hygiene, using personal protective equipment, allowing workers to stay home to take care of sick family members, and telecommuting—could be providing antiviral drugs prophylactically, or before the employees get sick in an attempt to keep them healthy. Such use could even prevent excessive absenteeism, the guidance suggests, since workers will be more confident that they can stay healthy if they are taking the drugs or if the people around them are taking the drugs and not passing on the virus.
“Despite expanding recommendations for antiviral drug use, there are no current plans for a commensurate expansion of public sector stockpiles, and employers will have to take the lead role for protection of their workforce if these recommendations are to be implemented,” the guidance cautions.
Once the pandemic strain emerges and is identified, based on current technologies, it will take at least 20 weeks before the first doses of a pandemic vaccine are available, the guidance states. However, two antiviral drugs, oseltamivir (Tamiflu) and zanamivir (Relenza), are good choices to combat many strains of flu. The drugs are being purchased for the Centers for Disease Control and Prevention’s Strategic National Stockpile for use during a pandemic. These drugs have been made available for state purchases for state-level stockpiles. Resistance to these drugs has been uncommon in human and avian influenza viruses to date.
During the process of developing the guidance, federal government representatives met with representatives from state and local government, public health, health care and emergency services, businesses, organized labor and the public. Employers said they needed help to plan and prepare for antiviral stockpiling. Barriers to employer stockpiling include cost of the medication, storing and dispensing the drugs, shelf life of the drugs, legal issues, potential liability concerns, logistical issues, and the potential for local or state government seizure of the drugs.
In response, the guidance stated that public officials are discouraged from seizing employer drug supplies. The secretary of the Department of Health and Human Services at the time of the guidance’s issuance said that obtaining antivirals through any means other than voluntary means would “undermine national preparedness efforts and should be discouraged.”
To comply with state and federal laws and regulations, employers should review state laws, consult with state boards of pharmacy, and talk to their occupational health providers, legal counsel, and health insurance and other insurance carriers. Employers must address any privacy and discrimination issues that might arise in deciding who will receive antivirals and in dispensing the drugs. These decisions might raise concerns about equity. See the guidance for tips on good decision-making, as well as suggestions on how employers can store and dispense the medications.
Beth Mirza is an editor for SHRM Online.