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Officials say they did not pre-order flu treatments, as suggested by the CDC, because of tight budgets.

By NOEL K. GALLAGHER, Staff Writer May 2, 2009

State officials on Friday defended their decision to not stockpile flu treatment medicine in Maine, despite a federal recommendation that each state have enough on hand to treat 25 percent of its population.

The decision was based on the state's financial situation, officials said Friday.

"These are severe economic times and you have to make difficult decisions at times about priorities," said David Farmer, deputy chief of staff for Democratic Gov. John Baldacci. "Hindsight is 20-20."

Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention, agreed. "There are a lot of budget priorities that have to be weighed," she said. "Other states have had the same challenges."

An Associated Press survey of all 50 states and the District of Columbia found that Maine was among 29 that did not stockpile the federally recommended amount of medicine. The government offered states a subsidy to cover 25 percent of the cost, although many states passed, citing budget costs and the five-year shelf life of the antivirals.

Despite this, the acting head of the U.S. Centers for Disease Control and Prevention said no state is expected to experience shortages because the federal government is racing to fill states' stockpiles with millions of additional doses from its own strategic reserves.

Maine will get its emergency shipment of about 50,000 doses as early as Sunday, Mills said. Each dose is enough to treat an individual with the flu.

Farmer noted that the Baldacci administration had earmarked $2.175 million in the 2010-11 budget for antivirals.

That money is now being used immediately to purchase flu treatment doses. Baldacci signed an executive order earlier this week to buy the antivirals – about 500,000 doses – which should arrive in the next 10 days, Farmer said.

Farmer said the antiviral money was in the current budget because it was a priority item.

"We thought it was prudent, not that we had any indication this was coming," Farmer said. "You are always forced to balance resources between what you have to do, what you'd like to do and what you can't do. If you spend (the money) on antivirals, then you are not spending it on mental health or education or other things."

For now, the only flu treatments in Maine are through pharmacies and hospitals.

Hospitals tend to keep about 20 or so doses on hand at any given time, according to regional health officials.

Pharmacies tend to have large supplies at the beginning of flu season, taper off ordering at the end and don't stock any during the off-season.

Dr. Don Burgess of Kennebunk wrote about 30 prescriptions for Tamiflu this week. He is the consulting physician for Kennebunk Elementary School and The Crayon Academy day-care in Arundel, both of which were closed because two students there, siblings, were considered "probable" swine flu cases. Tests on the Crayon Academy child came back negative Friday, and the day-care center will be allowed to open Monday.

Burgess said he ordered flu treatments for all students under age 5 at the academy, telling parents to get the treatments from Southern Maine Medical Center, which has several hundred doses on hand.

But concern about a shortage led him to prescribe a five-day course of drugs, instead of the usual 10-day treatment, he said. Five days is enough to treat the flu, and because of the global nature of the crisis, the CDC is recommending that doctors prescribe a five-day treatment, he said.

"Part of what's going on is that we're at the end of flu season. It wasn't a great time to have a flu outbreak," Burgess said. "It would be nice to have more (medicine available), but we can get it in a few days."

Paul Weiss, a spokesman and analyst for the Regional Resource Center at Maine Medical Center, said that although most hospitals do not have reserve flu treatments, they usually have standing...