e Canada has taken the highly unusual step of halting the sale of Tamiflu, thought to be the best defence against an avian influenza pandemic, after the drug maker experienced a higher-than-normal demand for the antiviral medication.
Under the heading of "urgent," the firm sent a letter to Canadian pharmacies, stating that shipments of the drug oseltamivir phosphate will end immediately until flu season begins.
When flu season hits, typically from December to March, nursing homes and other institutions will get priority, it wrote.
"Roche Canada has decided to proactively manage the Tamiflu inventory," it wrote in the letter obtained by The Globe and Mail. "This flu season, the company will prioritize distribution of Tamiflu to those patients most at risk of developing serious influenza-related complications once the influenza season begins."
Lothar Dueck, president of the Coalition of Manitoba Pharmacies, called the move unprecedented, saying he has never seen a drug maker suspend sales of its own product in his 28 years as a pharmacist.
"Enormous amounts of the capsules are being gobbled up and hoarded by panicking Canadians," Mr. Dueck said in a telephone interview from Ottawa last night, where he is attending a meeting of health ministers from around the world discussing pandemic preparations.
"The drug company is doing what our government should be doing -- it's protecting the Canadian drug supply."
A Health Canada spokesman could not be reached for comment last night.
Mr. Dueck said he believed Internet pharmacies, which ship across Canada and also to the United States, were responsible for a chunk of the increased sales.
However, Andy Troszok, president of the Canadian International Pharmacy Association, which represents Internet or mail-order pharmacies, said there has only been a marginal, or 5-per-cent, increase in sales of Tamiflu, which can be obtained only with a doctor's prescription.
Some 4,061 prescriptions were written for Tamiflu in September, compared with 421 in the same month last year, according to Sue Cavallucci of IMS Health, a private health-information and consulting-services company that serves the pharmaceutical and health-care industries.
Widely used in nursing homes during flu season, the drug attacks the influenza virus and stops it from spreading inside the body. More than 53,000 prescriptions were written for it in February and March this year, according to IMS.
Yesterday, federal Health Minister Ujjal Dosanjh said drug companies may be forced to share their patents if world production of antiviral medicine and vaccines is to keep pace with demand.
"There are countries that have the capacity to manufacture vaccines or antivirals that we actually need to assist with technology transfer, which is a euphemism for loosening patent laws," he said yesterday at the opening of an international conference on pandemic preparation in Ottawa.
The conference, which attracted health ministers and other officials from 30 countries, will focus on that kind of issue, Mr. Dosanjh said.
Dr. Lee Jong-wook, the director-general of the World Health Organization, who is also attending the conference, said Roche has agreed to share its licence for Tamiflu with other drug companies to help increase supply. It has also promised to give 30 million capsules, free of charge, to the WHO to send to the "front lines" of a pandemic.
"When there is a real need of Tamiflu, the basic instinct will be this is for our people," Dr. Lee said. "It is a very unnatural act to share these precious small quantities of medicine with others."
In Canada, the federal, provincial and territorial governments have stockpiled 35 million Tamiflu pills, Julian Beltrame, manager of media relations for the Public Health Agency of Canada, said last night.
Some physicians -- who expect to be on the front line treating patients with the disease -- have amassed pills to be taken as a prophylaxis, to prevent the disease.
One of them is Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital, who will be at the forefront of an avian flu pandemic.
Dr. Low, who is also the medical director of the Ontario Public Health Lab, said he paid for 100 pills out of his own pocket, even though the capsules are covered under most private health plans.
"I thought about this a couple of years ago and I kept saying, 'I'm going to do this,' . . . and finally I did it," Dr. Low said yesterday.