Each month, the Prescrire editorial staff presents systematic and comparative analyses of available data on newly approved drugs in France, and on new therapeutic indications approved for existing drugs.

The aim is to help the reader distinguish, among the plethora of lavishly promoted new commercial products, those medications worth adding to their drug list or worth using instead of existing drugs.

Rigorous procedures
This evaluation follows rigorous procedures that include a thorough literature search, a large panel of reviewers (specific to each project) and a quality control system to check that the text is consistent with the data in the references.
> Click here for details on how a review in Prescrire is produced.

Independence
This work is carried out by the editorial staff in total independence. Prescrire is financed exclusively by individual readers’ subscriptions, neither the French nor the English edition carries any paid advertising, nor do we receive grants or subsidies of any kind (see our annual financial report in each June issue). At the end of each year, the Prescrire Drug Awards are based on the review articles published that year, and take into account any new data available since the initial articles were published.

The rules
Therapeutic advance is defined as better efficacy, fewer or less severe adverse effects (for similar efficacy), or safer or more convenient administration. The rules governing the Drug Awards are available online.
> Click here to download the rules (pdf 254 Ko, in French).

2008: a few improvements in convenience only this year
In 2008, for the first time since the Drug Awards began in 1981, no drugs have been awarded the Golden Pill or mentioned on the Honours List.

However, 3 products contributed to patient care through improved convenience. In 2 cases, a substance with a well-known and clearly favourable risk-benefit balance (metformin and methadone) was marketed in an awaited new pharmaceutical form. Although the packaging of the methadone capsules is particularly well designed (see the Packaging Awards), considerable restrictions apply to access to this product in France. The third case is a new indication for a thrombolytic agent (urokinase) marketed since the 1980s, in a situation where its use was already commonplace.

React
The paucity of new products providing even modest advantage stands in contrast to the increasing number of new products that expose patients to unjustified risks. Above all, this seems to reflect the inadequacies of the licensing procedures and the failure of the international system to encourage therapeutic advances. There is an urgent need for the authorities (and pharmaceutical companies) to change course. It is up to patients and health professionals to see to it that it happens.

And it is in patients’ and health professionals’ interests to make best use in everyday practice of the qualities of the essential drugs on the market.

©Prescrire April 2009

Source: Prescrire Int 2009; 18 (100): 81.