Health Q&A: When stockpile drugs expire

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What happens when stockpile drugs expire Q:What happens when drugs in the federal stockpile reach their expiration date and have not been used?

Answer: The Strategic National Stockpile contains medications and supplies that would be needed in a mass disaster or other emergency. Examples of emergencies include a pandemic flu outbreak, hurricanes and terrorist attacks.

The stockpile includes such drugs as the flu medicine Tamiflu and the antibiotic Ciprofloxacin, as well as medical supplies, such as those for administering drugs intravenously or for keeping a patient's airway open.

Virginia, for instance, received 280,000 treatment courses of flu drugs from the federal stockpile in the recent H1N1 swine-flu scare. The state already had nearly 800,000 treatment courses of antivirals in its own stockpile.

A stockpile can consist of drugs on hand in an existing inventory, or it can be vendor-managed inventory that a state has contracted to purchase.

According to the U.S. Centers for Disease Control and Prevention, the federal stockpile is routinely checked to make sure the items are within their recommended shelf life. That's done by making quarterly checks on some items and an annual inventory, which includes inspections of environmental conditions, security and overall package maintenance.

Now that it looks as if the stockpile drugs sent to states might not be needed anytime soon, what happens, for instance, to the 280,000 extra treatment courses Virginia received?

States will likely get to keep the drugs, a state official said.

The shelf life of some stockpile drugs can be extended beyond their expiration date under the Food and Drug Administration's Shelf Life Extension Program. That effort started as a way for the Department of Defense to save money by not having to throw away drugs that were still usable just because the expiration date had passed.

Tamiflu has qualified for that program. Batches or lots of Tamiflu in the stockpile that meet rigorous testing standards can have the shelf life extended from five years to seven years.

When drugs from the stockpile are used, it's done under FDA Emergency Use Authorizations. The FDA issues special letters to consumers and special prescribing instructions for health-care providers.

What about stockpiled vaccine? Under pandemic-flu planning scenarios, the U.S. proposes having enough of a pandemic-flu vaccine to immunize 20 million people. Vaccines also could be stockpiled but would lose potency over time and after about three years would have to be replaced. Replacing vaccine stockpile could cost anywhere from $300 million to $700 million by some estimates.

Another thing to think about: If the H1N1 virus or any other flu strain that sets off a pandemic mutates, stockpiled vaccine may not be effective.

For more on the Strategic National Stockpile, go to: http://emergency.cdc.gov/stockpile/.

Contact Tammie Smith at (804) 6496572 or .