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article imageThe failure and cost of Tamiflu

By Tim Sandle     Apr 10, 2014 in Health
London - Hundreds of millions of dollars may have been wasted in the U.K. on a drug for flu that works no better than paracetamol, according to a new scientific report.
The report has been issued by The Cochrane Collaboration. The report notes that the U.K. spent over $600 million (£473 million) on Tamiflu (also known as oseltamivir). This was similar to many other world governments, which stockpiled the drug to prepare for flu pandemics.
There was one problem: Tamiflu doesn't appear to be very effective. The Cochrane Collaboration have reported that the drug did not prevent the spread of flu or reduce dangerous complications, and only slightly helped symptoms. The reduction in symptoms was not to the extent that the huge cost could be justified. The Cochrane Collaboration is a global not-for-profit organisation of 14,000 scientists.
The review concludes that the drug reduced the persistence of flu symptoms from seven days to 6.3 days in adults and to 5.8 days in children. The issue is, the Daily Telegraph summaries, is that drugs such as paracetamol could have a similar impact.
Ben Goldacre, author of the books Bad Science and Bad Pharma, provides a succinct analysis:
"So does Tamiflu work? From the Cochrane analysis – fully public – Tamiflu does not reduce the number of hospitalisations. There wasn't enough data to see if it reduces the number of deaths. It does reduce the number of self-reported, unverified cases of pneumonia, but when you look at the five trials with a detailed diagnostic form for pneumonia, there is no significant benefit. It might help prevent flu symptoms, but not asymptomatic spread, and the evidence here is mixed. It will take a few hours off the duration of your flu symptoms. But all this comes at a significant cost of side-effects."
Tamiflu is manufactured by Hoffmann-La Roche. The drug is an antiviral licensed to prevent or slow the spread of influenza A and influenza B (flu) virus between cells in the body by stopping the virus from chemically cutting ties with its host cell. The drug itself is not virally effective; however, once in the liver it is hydrolysed to its active metabolite — the free oseltamivir carboxylate.
The Guardian is critical about the practices of the manufacturer and notes that had all of the research data been known at the time — that the drug is not that effective — then governments would probably not have spent so much money on stockpiling the medication.
Talking to the BBC, Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, has said quite pointedly: "I think the whole £500m has not benefited human health in any way and we may have harmed people. The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled."
More about Tamiflu, paracetamol, Flu, Influenza
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