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Health Letter, January 2010
Sidney M. Wolfe, M.D.
Millions of healthy people and their doctors have flocked to use the anti-flu drug Tamiflu (oseltamivir) in the hope that it will prevent death or other serious complications of the flu. In October, record numbers of prescriptions, 2.5 million for Tamiflu, manufactured by Roche, were filled in the U.S. This is more than 70 times higher than the 35,000 prescriptions filled in October, 2008. For the last 12 months, there were 6.8 million prescriptions filled, compared with 4.3 million the previous 12 months.
The problem with this hopeful picture – and an explanation for the astounding sales – is that Roche appears to have put a positive spin on the data supporting Tamiflu’s ability to reduce the likelihood of serious complications of the flu.
But a joint investigation by the British Medical Journal (BMJ) and British TV Channel 4 published in the BMJ on Dec. 8 concluded that in otherwise healthy adults they “have no confidence in claims that oseltamivir reduces the risk of complications and hospital admission in people with influenza” and believe it should not be used in routine control of seasonal influenza. There was also concern about under-reporting of side effects of the drug.
In contrast, according to the BMJ, Roche has stated in media briefings that oseltamivir reduced hospital admissions by 61 percent; secondary complications (including bronchitis, pneumonia, and sinusitis) by 67 percent in otherwise healthy individuals and lower respiratory tract infections requiring antibiotics by 55 percent.
BMJ editor Dr. Fiona Godlee said “claims that oseltamivir reduces complications have been a key justification for promoting the drug’s widespread use. Governments around the world have spent billions of pounds on a drug that the scientific community has found itself unable to judge.”
There is evidence that oseltamivir has a modest effect in reducing some minor flu symptoms and contagiousness in otherwise healthy adults by about one day, but this is probably not the main reason most doctors are prescribing the drug for their patients. This less important benefit may well be offset by the risks of the drug.
We therefore strongly agree with the statement that in healthy adults, oseltamivir should not be used in routine control of seasonal influenza.
In addition, we support the call for more independent review of all of the raw data from company-funded clinical trials, something that has been missing in the case of oseltamivir and many other drugs.