Free Tamiflu will soon be available to some uninsured Utahns, in an effort to stop the spread of H1N1 swine flu.
The state has agreed that its publicly-funded stockpile of antiviral medication can be used to treat uninsured patients and their household contacts, as long as they have underlying health problems that put them at greater risk of serious complications, according to the Utah Department of Health.
Those conditions include being pregnant, being under age 5 and having chronic medical conditions, such as asthma and diabetes.
But the free pills won't be available right away. The state health department and the state's 12 local health departments have yet to work out the details, such as whether the drugs will be distributed through the government or at hospitals.
Utah received 25 percent of its share of the Strategic National Stockpile of antivirals in April -- 87,000 doses, adding to the 55,000 it already had on hand.
There has been hesitancy to use the stockpile during the H1N1 outbreak because private pharmacies can order the drugs. And, public health officials want the stockpile available in the fall and winter, when they fear the now-mild flu could morph into something more virulent.
The fact that the stockpile will be released now "suggests the illness in Utah seems to be a little more robust than in other parts of the country," said Gary Edwards, executive director of the Salt Lake Valley Health Department. And, he said, "we recognize there are members of our community who are at high risk who don't have insurance or other ways to pay for the [$90] medication."
The Utah Hospitals and Health Systems Association requested that the stockpile be released for the uninsured. The association's Debra Wynkoop said hospitals are seeing and diagnosing the uninsured, but have no way to treat them.
"We give them a prescription to go fill and they're coming back to the hospital even sicker because they didn't fill the prescription. They didn't have the money," she said.
It will be up to a doctor to decide whether a prescription is warranted, according to the state health department. While some doctors have been waiting for a confirmed flu test to write a prescription, those tests have a high false negative rate and the state has urged doctors to use their clinical judgment. If people exhibit flu-like symptoms, they likely have H1N1.
The new policy won't help Patricia Ravera, who e-mailed The Salt Lake Tribune to ask where she can get treatment because she is uninsured. Her daughters, who are covered by Medicaid, were diagnosed with the flu and got Tamiflu. But Ravera and her brother couldn't find a low-income clinic that is accepting new patients to get diagnosed. They both had fevers and were vomiting. She said she was bounced around between their health department and her children's doctor.
Ravera, of Provo, doesn't have an underlying health condition that would qualify her for the free drugs. She has stayed home to limit the spread.
"Of course I have frustration with the system," she wrote in Spanish. "Nobody is worried for us."
The picture is different for the insured.
Glen Worthington, of East Millcreek, said his family easily got prescriptions for Tamiflu two days after his 7-year-old daughter came down with flu-like symptoms this week. His wife has asthma, but neither he nor his daughter have underlying risk factors and they still got treated.
"Let's just attack it," was the doctor's attitude, said Worthington, who has insurance.
The 211 Information and Referral line is seeing an increase in uninsured Utahns asking where to go if they have flu-like symptoms or have been exposed. Nearly 80 people had called this week as of Thursday, 20 more than last week. Callers are referred to federally subsidized community health centers, which aren't taking new patients in Salt Lake County, and Intermountain Healthcare clinics.
Health officials do not yet know when the antiviral medications being released by the state will be available. They are currently deciding how to distribute them.