Academic Journal
The global demand and potential public health impact of oral antiviral treatment stockpile for influenza pandemics.
| Τίτλος: | The global demand and potential public health impact of oral antiviral treatment stockpile for influenza pandemics. |
|---|---|
| Συγγραφείς: | Han AX; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands., Hulme KD; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands., Russell CA; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands. |
| Πηγή: | Proceedings of the National Academy of Sciences of the United States of America [Proc Natl Acad Sci U S A] 2026 Aug 04; Vol. 123 (31), pp. e2524161123. Date of Electronic Publication: 2026 Jul 28. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: National Academy of Sciences Country of Publication: United States NLM ID: 7505876 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1091-6490 (Electronic) Linking ISSN: 00278424 NLM ISO Abbreviation: Proc Natl Acad Sci U S A Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Washington, DC : National Academy of Sciences |
| Ιατρικοί όροι (MeSH): | Antiviral Agents*/supply & distribution , Antiviral Agents*/therapeutic use , Influenza, Human*/drug therapy , Influenza, Human*/epidemiology , Influenza, Human*/mortality , Influenza, Human*/prevention & control , Pandemics*/prevention & control , Public Health* , Strategic Stockpile*, Triazines/supply & distribution ; Triazines/therapeutic use ; Oseltamivir/therapeutic use ; Oseltamivir/supply & distribution ; Morpholines/supply & distribution ; Morpholines/therapeutic use ; Dibenzothiepins/supply & distribution ; Dibenzothiepins/therapeutic use ; Pyridones/supply & distribution ; Pyridones/therapeutic use ; COVID-19/epidemiology ; Thiepins/supply & distribution ; Thiepins/therapeutic use ; Humans ; Administration, Oral ; SARS-CoV-2 ; Pandemic Preparedness ; Global Health |
| Περίληψη: | Antiviral drugs are among the few countermeasures available during the critical interval between the emergence of a novel influenza pandemic and vaccine availability. Antiviral stockpiling is a key pandemic preparedness measure, yet existing stockpiling estimates vary widely and rest on outdated assumptions about healthcare-seeking behavior and drug-specific effectiveness-limitations that the COVID-19 pandemic and recent clinical trial evidence have made untenable. We developed a multiscale transmission model incorporating heterogeneous healthcare-seeking behavior and direct clinical estimates of antiviral transmission risk reduction to estimate country-specific demand and mortality impact across four pandemic scenarios in 186 countries. We find that baloxavir marboxil (BXM), due to its transmission-reducing potential, could avert 37 to 68% of mean pandemic deaths in the first epidemic wave, approximately double the impact of oseltamivir, while requiring a mean stockpile approximately 5 to 10% smaller (7 to 34% of the population, compared to 28 to 36% for oseltamivir). Uncertainty in viral load dynamics and transmission reduction benefits from clinical trials means that BXM's impact could vary, but sensitivity analyses consistently suggest that BXM is likely to be more effective than oseltamivir. Under limited drug availability, priority should be given to treatment over postexposure prophylaxis. Although drug rationing for high-mortality populations (e.g., elderly) can substantially reduce BXM demand, doing so leads to greater total pandemic deaths. Critically, each week of delay in initiating antiviral distribution erodes impact by up to 3% of averted deaths, meaning that antiviral stockpiles must be accompanied by rapid deployment infrastructure to deliver their potential impact. |
| Competing Interests: | Competing interests statement:The authors declare no competing interest. |
| Grant Information: | 818353 EC | European Research Council (ERC); 10710062310004 ZonMw (Netherlands Organisation for Health Research and Development); 09150162210121 ZonMw (Netherlands Organisation for Health Research and Development); 09150182010027 ZonMw (Netherlands Organisation for Health Research and Development) |
| Contributed Indexing: | Keywords: antiviral stockpiling; influenza pandemic; oral antivirals; pandemic preparedness; public health |
| Substance Nomenclature: | 0 (Antiviral Agents) 0 (Triazines) 20O93L6F9H (Oseltamivir) 4G86Y4JT3F (baloxavir) 0 (Morpholines) 0 (Dibenzothiepins) 0 (Pyridones) 0 (Thiepins) |
| Entry Date(s): | Date Created: 20260728 Date Completed: 20260729 Latest Revision: 20260807 |
| Update Code: | 20260807 |
| PubMed Central ID: | PMC13439088 |
| DOI: | 10.1073/pnas.2524161123 |
| PMID: | 42520120 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1091-6490 |
|---|---|
| DOI: | 10.1073/pnas.2524161123 |