Optimizing Distribution of Pandemic Influenza Antiviral Drugs

We provide a data-driven method for optimizing pharmacybased\ndistribution of antiviral drugs during an influenza pandemic\nin terms of overall access for a target population and\napply it to the state of Texas, USA. We found that during the\n2009 influenza pandemic, the Texas Department of State\nHealth Services achieved an estimated statewide access of\n88% (proportion of population willing to travel to the nearest\ndispensing point). However, access reached only 34.5% of\nUS postal code (ZIP code) areas containing <1,000 underinsured\npersons. Optimized distribution networks increased\nexpected access to 91% overall and 60% in hard-to-reach\nregions, and 2 or 3 major pharmacy chains achieved near\nmaximal coverage in well-populated areas. Independent\npharmacies were essential for reaching ZIP code areas\ncontaining <1,000 underinsured persons. This model was\ndeveloped during a collaboration between academic researchers\nand public health officials and is available as a\ndecision support tool for Texas Department of State Health\nServices at a Web-based interface.