english.prescrire.org > Spotlight > Archives : 2007 > Rimonabant: expensive, only partially reimbursed and with an unfavourable benefit-risk balance

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Rimonabant: expensive, only partially reimbursed and with an unfavourable benefit-risk balance

Rimonabant should be avoided due to its unfavourable benefit-risk balance in obese patients, whether they are diabetic or not.

Rimonabant is an appetite suppressant drug derived from cannabis. There was a massive advertising campaign promoting it even before it came onto the market.

While the French Health Minister has agreed to reimburse 35% of the cost of the drug for some patients, it must be kept in mind that the clinical trials conducted on rimonabant as a treatment for obesity showed only a modest effect on weight loss (4 to 5 kg after one year) and no improvements in terms of morbidity/mortality.

In diabetic patients, weight loss is minimal and there is no evidence that rimonabant reduces complications associated with diabetes. The adverse effects of rimonabant are short-term and chiefly psychological, neurological and digestive. Its long-term adverse effects are unknown.

In other countries, the authorities are being more cautious: the US drug regulatory agency has postponed its decision on granting a marketing authorisation; the German authorities have classified it as a comfort drug and refuse to reimburse it.

It is appalling that the French authorities have agreed to reimburse rimonabant, albeit at 35% and only for some patients, in spite of its unfavourable benefit-risk balance. ©Prescrire May 2007

Source: "Rimonabant : remboursable mais à éviter" Rev Prescrire 2007 ; 27 (283) : 341.

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