Tamiflu unpopular with S'pore doctors

SINGAPORE - Controversial anti-flu drug Tamiflu appears to be unpopular among GPs in Singapore, with many saying they do not stock it due to its high cost and "unproven" effectiveness.

Of 20 GP clinics The Straits Times spoke to, 15 did not sell Tamiflu and 11 had never stocked it.

On Thursday, non-profit organisation The Cochrane Collaboration and the British Medical Journal published a study on the drug's effectiveness.

The study, which involved more than 24,000 people, concluded that there is no evidence Tamiflu stops the spread of the flu virus or reduces complications that follow.

It urged governments around the world to reconsider stockpiling Tamiflu, which many did during the H1N1 outbreak in 2009.

It was one of the most popular drugs stocked by GPs during the crisis.

A Singapore doctor, who declined to be named, said one reason she chose not to stock the drug was that it is "not cheap".

"Some patients have told me there's not much difference if they take Tamiflu or not," she added.

"If they come to me with a flu, I prescribe medicine for symptom relief and tell them to get rest."

Another local GP, Dr Teh Kin Chiang, said the drug was very popular during the H1N1 crisis, but is no longer so.

"It's never been very effective," the 69-year-old added. "It doesn't help much even with symptom relief."

He, too, has never prescribed Tamiflu to his patients.

Four clinics told The Straits Times they order it only if a patient specifically requests it.

"We used to stock it," said Dr Heng Kuan Yong, 42, referring to the H1N1 crisis period. "At that time, there were a lot of requests, but now there is no demand, and we seldom bring it in." The last request he received for Tamiflu was two or three years ago.

The Health Ministry said it will study the Cochrane report and its evidence.

A ministry spokesman said the Government has built up a national stockpile of antiviral drugs including Tamiflu and Relenza, which is another anti-flu drug.

The size of this stockpile is sufficient to treat the projected number of influenza patients and as a preventive measure for essential service personnel, the spokesman said.

"Based on data from previous pandemics... up to 25 per cent of the population may be infected in a pandemic," the spokesman said.

However, the ministry declined to reveal the exact size of the Government's current Tami-flu stockpile and the amount it has spent on stockpiling to date.

In 2010, it was reported that the ministry had enough of the drug to treat 1.39 million adults and 300,000 children. Doctors say Tamiflu costs between $45 and $70 for a box of 10 pills.

Professor Paul Tambyah, a senior consultant with the National University Hospital's division of infectious diseases, said drugs like Tamiflu are just "one of a variety of approaches to controlling an influenza pandemic".

"In addition to (drugs), there are also basic public health measures such as good surveillance... and appropriate isolation of cases," he said.

"All these are essential components of Singapore's well-designed pandemic plan."

This article was published on April 12 in The Straits Times.

Get a copy of The Straits Times or go to straitstimes.com for more stories.