THE NATIONAL PHARMACEUTICAL STOCKPILE (NPS) PROGRAM

2001 Centers for Disease Control and Prevention

National Center for Environmental HealthDivision of Emergency and Environmental

Health Services

THE NATIONAL PHARMACEUTICAL STOCKPILE (NPS) PROGRAM

2001 Centers for Disease Control and Prevention

National Center for Environmental HealthDivision of Emergency and Environmental

Health Services

• Role of the NPS Program• Contents of the NPS• Capacity of the NPS• Transportation Operations/ Logistics• Accessing the NPS• Obtaining Technical Assistance

Program Review

Role of the National Pharmaceutical Stockpile (NPS) Program

“to maintain a national repository of life-saving pharmaceuticals and medical materiel that will be delivered to the site of a chemical or biological terrorism event in order to reduce morbidity and mortality in civilian populations.”

What’s in the NPS?

Pharmaceuticals

Antibiotics doxycycline ciprofloxacin gentamicin erythromycin

Chemical agent antidotes atropine pralidoxime (2PAM) diazepam

Pharmaceuticals Other Medications

dopamine epinephrine methylprednisolone albuterol inhaler morphine lorazepam

Medical / Surgical Supplies

IV Administration Supplies Sterile Water For Injection NaCl flush Syringes/needles/catheters Y site administration sets IV solutions Gloves Tape/ dressings/ gauze/

tourniquets Alcohol pads, betadine

swabs, antibiotic ointment

Medical/Surgical Supplies Airway Management Supplies

ET tubes/ stylettes NG tubes Oropharyngeal airways Laryngoscopes Oxygen masks/ tubing Manual resuscitators (bag-valve-mask) Ventilators and suction units Pediatric and adult sizes where applicable

Medical/Surgical Supplies

Other

Tablet counting machines Power strips Extension cords Duct tape Zip lock baggies

Other Pertinent Information Patient information sheets, provider

information sheets, data collection sheets

How is the NPS Packaged?

NPS Components

• 12-Hour Push Packages:– Ready for deployment to reach designated airfield within 12

hours of Federal activation– Pre-positioned in environmentally controlled and secured

facilities – Pre-configured for rapid identification and ease of distribution

• Vendor Managed Inventory (VMI) Packages:– Will be shipped to arrive within 24 and 36-hour periods – Are comprised of pharmaceuticals and supplies that are

delivered from one or more VMI sources – “Tailored" to provide specific materiel depending upon

suspected or confirmed agent

A Two-Tiered Response

How Many People Can a 12-hour Push Package

Care for?

Capacity for Treatment: (Plague, Tularemia, Anthrax)

• One 12-hour Push Package can provide:Prophylaxis for:

357,000 people X 7 days.

Therapeutic treatment for:

6,000 people X 7 days.

• The Push Package is designed to be followed by VMI

• Number of days of medication is scenario driven

Note- Therapeutic Tx: treatment of symptomatic personsProphylaxis: preventive treatment of asymptomatic persons

What Does a 12-hour Push Package Look Like?

What will a 12-hour Push Package look like when it’s delivered?

Each NPS 12-hour Push Package:

•Occupies 124 cargo containers

•Weighs 94,424 pounds

•Measures 10,329 cubic feet

•Requires 5,000 square feet ground/floor space for proper staging and management

How Do We Get the NPS?

Readiness/ResponseHow NPS Assets are Deployed

State Requests Federal Assistance

2.Need for Drugs and Medical Supplies Exceeds Local & State Resources

1.

In Consultation with the Surgeon General, Secretary HHS, HHS Office of Emergency Preparedness (OEP), FEMA and the FBI

Augments Local/State

MedicalMateriel

Resources

National Pharmaceutical Stockpile (NPS)

4.

Director of CDC

Deploys NPS Assets

3.

Delivery to Public

• Reception

• Initial breakdown

• Repackaging

• Resource mgt/ allocation

• Distribution to

Points of Dispensing (POD)

•Dispensing

•Identify PODs

•Set-up PODs

•Staffing

•Equipment

•Security

State Local

Request for Push Package

“One State’s View” *

* Adapted from the State of Colorado

Will Someone from the CDC be at the Airfield to Help with the

National Pharmaceutical Stockpile?

NPS Technical Advisors • Advisors include pharmacists,

public health experts, and emergency response specialists

• Hand-off materiel to authorized state representative (in accordance with state plan)

• Assist in distribution of materiel to the state/local point(s) of dispensing (PODs)

• Coordinate closely with incident command structure (State and Federal EOCs)

• Maintain continuous contact with the CDC NPS Program Operations Center

• Available for a range of technical assistance

Readiness/Response

Are there any Guidelines for Planning for the NPS?

• In Draft form:“State Planning Guidance for Receiving, Organizing, Repackaging and Distributing the National Pharmaceutical Stockpile”

• Premise: Approved Deployment of the National Pharmaceutical Stockpile – Deployment Algorithm

• Distributing vs. Dispensing

• How to Reach Us (non-emergency)• Points of Contact: 770-488-7516

• Ken Archer• Steve Reissman• Steve Skowronski

• Secure List Serv• Training Opportunity with NPS (IPA)

Next Steps

Additional Information

State / Local Issue:Distribution of Materiel from Airport

• Personnel/Equipment to – Unload Cargo

Containers – Load trucks

• Vehicles (public, private, military)• Personnel to drive vehicles• Methods/Distribution/Bulk Product

Breakdown points • Security of materiel and personnel• Identifying key personnel contacts

State/Local Issue:Storage and Handling of Materiel

• Climate control• Security• Ease of identification• Location of Materiel

– Proximity to patient treatment site[s] (selected hospitals)

– Proximity to mass prophylaxis dissemination site[s] (not hospitals)

– Proximity to airport

• Controlled Substances

State/Local Issue:Treatment Protocols

• SOPs for treatment of adults, children, immunosuppressed and geriatric populations

• Patient Information Sheet/Care Instructions

• Transfer of symptomatic patients from treatment site to definitive care site

• Mass prophylaxis and/or immunization of at-risk asymptomatic populations

• Patient tracking/follow-up