Gpo Novation

Influenza Vaccine Update Pharmacy Purchasing Outlook August 8, 2006

Larry Eros, R.Ph. Senior Director Pharmacy Contract Management Novation

2006-07 Influenza Vaccine (CDC) Expected production for the 2006/07 flu season: US Market Sanofi Pasteur (Fluzone) 50 mm doses Novartis (Fluvirin) 40 mm doses GSK (Fluarix) 7-9 mm doses GSK (Flulaval) 15-20 mm doses if FDA approved Medimmune 3 mm inhaled doses Low/High 2005/06 demand

112/119 million doses 90 million doses

2007/2008 season – CSL Limited Australia, potential new market entry (parent company of ZLB)

Dose Breakout by Provider • • • • •

Physician offices Hospitals/LTC Public Health VNAA Retail

35% 26% 26% 8% 5%

Supply Versus Demand Challenges SUPPLY •

•

• •

Manufacturing difficulties – Chiron – Sanofi Pasteur cannot supply the entire US market Production capacity – Plant capacity and production scheduling support a system where most doses are delivered over a 4-month period of time. Market demands doses in early October. Where are the doses going? – Currently no national tracking system for influenza vaccine doses Flu vaccine waste – Suppliers are not willing to continue throwing away millions of doses each year.

Supply Versus Demand Challenges DEMAND • Demand must be stimulated in order to keep manufacturers in the market • How? – CDC begins heavy public awareness campaign in September, but supply cannot keep up with demand – High risk message – early doses not always reaching high risk population. Allocation process is at a very high level. • Providers double and triple book flu vaccine orders to ensure availability, but that practice skews actual demand.

Communication challenges Manufacturer level • Suppliers are reluctant to provide specific information about shipping dates and amounts expected. • Distributors depend on suppliers information Provider level • Healthcare providers don’t have a clear message for the public about when to expect vaccine. Clinics have to be changed on short notice and sometimes cancelled. CDC level • Must communicate not only to the public but to other organizations (JCAHO, etc) about supply status and must be clear about the change in message in the event of a dose shortage, or late season arrival

Call to Action • Eliminate double-booking doses quantities • Schedule clinics during CDC recommended dates (mid-October to mid-November) • Keep your order confirmation numbers, faxes, e-mails in a SAFE PLACE!

Questions?