All drugs are not equal. In certain situations, drug treatments are useful, representing a therapeutic advantage over other options. Other drugs are more harmful than useful, and ought to be avoided in the course of providing healthcare, until these drugs are withdrawn from the market.

Analysis carried out by Prescrire’s editors from 2010 to 2013 has identified 68 drugs currently on the market in France that are more harmful than useful.

These include :

• Drugs that are effective, but, in the context of the clinical situation, expose patients to risks that are disproportionate to the benefits that they deliver;
• Old drugs that are no longer useful, since other drugs have a more favourable harm-benefit balance;
• Recent drugs whose harm-benefit balance turns out to be less favourable than that of older drugs;
• Drugs which have no demonstrated efficacy, beyond a placebo effect, but which expose patients to serious adverse effects.

Prescrire’s evaluation of drugs is based on methodical and reproducible literature search, and a collective process of analysis which follows an established procedure:

• The ranking of data on efficacy, giving priority to evidence-based data, i.e. data that comes from well-conducted, randomised, double-blinded, comparative trials
• Comparison to a treatment of reference (drug or non-drug treatment), with a specific determination as to what is the best comparator treatment
• Determination of the clinical endpoints that are the most relevant for patients, often setting aside intermediate criteria that do not have a proven effect on patients’ quality of life

The point of this round-up is to encourage the choice of quality care, first to do no harm to patients, and to avoid doing damage.

©Prescrire 1 February 2014

"Pour mieux soigner, des médicaments à écarter : bilan 2014" Rev Prescrire 2014 ; 34 (364) : 137-143. (pdf in French, free)

"Choisir d'écarter" Rev Prescrire 2014 ; 34 (364) : 81. (pdf, in French, free)