Shoutout to the team: Katina Hulme & Colin Russell

“Antivirals…can play an incredibly important role in limiting the impact of the next influenza pandemic. However, the…benefits are only accessible if those drugs are…available when the next pandemic starts. This requires stockpiling now.” - Colin

Drug resistance could potentially emerge and spread but >25% of pandemic deaths averted if antivirals were distributed. That said, these benefits cannot be realised without an existing strong public health infrastructure to react, test and distribute antivirals promptly upon a future pandemic.

Giving prophylaxis to exposed household contacts could provide some additional burden reduction benefits but strongly depends on the country: Mean household size must be >4 to reap benefits but would also increase drug stockpile size substantially (>34% more drug courses per-capita).

We also find that drug rationing by age (i.e. treating those with higher mortality risk, often seniors, which is commonly done when drug stocks are limited) does not meaningully lower antiviral drug demand but can in fact lead to more pandemic deaths.

We’ve estimated country-specific stockpile size and impact for 186 countries, accounting for the age demography and likely pandemic burden expected in each country.

We find that baloxavir marboxil could potentially reduce 37-68% of pandemic deaths with treatment stockpile covering 7-34% of a country’s population. If oseltamivir is used instead, pandemic deaths reduction would be halved while requiring ~5-10% more drugs per-capita.

We developed a novel mathematical model that more realistically accounts for population differences in human health behaviour while incorporating recent clinical estimates of transmission reduction effectiveness by treatment with baloxavir marboxil.

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