Roche just announced they are sub-licensing Tamiflu broadly. WSJ picked up the story (subscription required) and noted that some countries aren’t waiting and have allowed generic production infringing Roche’s patents.

I was able to obtain some more Tamiflu today here in Austin at my local People’s Pharmacy. While there is apparently tremendous pressure on Roche at the international level, it looks like the rest of the supply chain has not yet picked up on the coming shortage and telegraphed the price rise. Gas prices these are not.

With no human to human transmission yet, it is hard to produce a vaccine because we do not know what the final pathogen will look like as it has not mutated yet. The risk is that it will spread quickly, but another risk is that it will not spread at all unfairly delegitimizing everyone who raised the warning.

It’s a lot to ask people to st0ckpile their own Tamiflu (40 doses is about $300 enough for two acute courses if you show symptoms or 40 days worth of deterrence). But it lasts for three flu seasons. Spending $100/person per year would be $30 billion/year. Roche might part with a license to sell at a few cents a pill in those volumes and the post office distribute it getting the price down to a few bucks a person a year.

But who will st0ckpile it for you if you don’t do it yourself? All it takes is 1% of families to buy to make personal st0ckpiling bigger than Roche’s US sales in a single flu season. There were only 13,000 prescriptions last year. So if 1% of families bought demand would be increased by a factor of a hundred. Then maybe the wheels of government would move to build some more “push packs” for flu and not just bioterror.

While we are talking good public health policy, maybe we could use Tamiflu prophylactically every year in hard hit regions and not wait for bird flu. This and other measures like more widespread vaccination outreach may even cut the tens of thousands of deaths from regular flu seasons down to the 160 of a typical hurricane season. It would also give the Center for Disease Control good practice.