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Drugs: not enough comparative data

Pharmaceutical companies and public authorities sometimes connive to cover up an unfortunate truth: the lack of comparative data on new drugs.

Comparing drugs in clinical trials leads to a better understanding of the drugs and improved use. But this essential information is often lacking because pharmaceutical firms are not obliged to compare their new drugs with those already available for the same indication in order to obtain a marketing authorisation.

Pharmaceuticals companies, who are increasingly demanding to be allowed to communicate directly with the public on disease and drugs, are fiercely opposed to the idea of being forced to supply objective comparative data on their drugs. This apparent paradox says a lot about the reliability and relevance of the "information" the companies wish to provide to the public.

Meanwhile, the position of the public authorities is ambiguous as they are torn between their duty to protect patients and their reluctance to antagonise pharmaceutical companies. The French Commission de la transparence, the body that assesses the medical benefits of new drugs, is mired in contradictions: its role is to give an evaluation of the therapeutic benefit (Amélioration du Service Medical Rendu, or ASMR), which is then taken into account by the economic committee for health products in its discussions on drug prices with the firms. The Commission actually granted "shared ASMRs" to two drugs, without comparing them! By allowing people mistakenly to believe that drugs have been compared, the expression "shared ASMR" is a prime example of unclear drugs information.

©Prescrire November 2006

Source: "Infliximab : les euphémismes de la Commission de la transparence" Rev Prescrire 2006 ; 26 (277) : 736-737.

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