Tamiflu: Less Effective and More Dangerous Than Initially Believed

Today’s Managing Health Care Cost Indicator is $10 billion

That’s how much the world spent on influenza preparedness in 2009; about $4 billion was spent in the US alone.  Two billion dollars were spent on purchase of Tamiflu (Olseltamavir).

However, there is increasing evidence that Tamiflu has more serious neuropsychiatric side effects than initially thought, and the evidence of its effectiveness appears to be overstated. There was a well-referenced review of this in the current issue of New York Review of Books. 

The initial approval of Tamiflu was based on a manufacturer-sponsored metaanalysis of ten studies
only two of which had been published in peer-reviewed journals.  Researchers associated with the Cochrane Collaboration initially published a positive review of the medicine, but have more recently been rebuffed in their efforts to obtain the primary data from those three studies.  The author of the metaanalysis has ‘lost’ the data, and  the pharmaceutical company which markets Tamiflu in the US has only been willing to share summary data. 

There are powerful reasons why initial small studies tend to overstate the effectiveness of a medication. That’s why we need more comparative effective research, which must be continued after a drug is approved for marketing. 

Keeping us safe from influenza, either avian or swine, is pretty important.  The FDA needs to do more to be sure that the drugs we spend billions on are both safe and effective.