english.prescrire.org > Spotlight > Archives : 2010 > French health authorities drag their feet: the example of nonsteroidal anti-inflammatories

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French health authorities drag their feet: the example of nonsteroidal anti-inflammatories

Despite an unfavourable harm-benefit balance, two nonsteroidal anti-inflammatories, celecoxib and piroxicam, are still on the market in France — for the benefit of the pharmaceutical companies, and to the detriment of patients.

As the price and level of reimbursement in France come down for celecoxib and piroxicam, two nonsteroidal anti-inflammatories (NSAIDs) with an unfavourable risk-benefit balance, the French health authorities have been prevaricating. Rofecoxib was withdrawn from the market due to its severe adverse effects, especially cardiovascular and cutaneous. Celecoxib, which belongs to the same family as rofecoxib, exposes patients to the same severe adverse effects, without being any more effective than the standard NSAIDs, and without offering any tangible benefit in terms of gastrointestinal effects. The reduction of the price of celecoxib is only a half-measure seeking to protect the pharmaceutical company’s interests, but at the expense of patient safety.

Piroxicam is another NSAID with an unfavourable risk-benefit balance, due to its sometimes severe gastrointestinal and cutaneous adverse effects. Instead of simply withdrawing it from the market, French health authorities have chosen to reduce its level of reimbursement, once again pandering to pharmaceutical companies' interests to the detriment of patient health.

Both these drugs should be purely and simply withdrawn from the market. Meanwhile, it is better to avoid these two NSAIDs in favour of another, such as ibuprofen, which has a favourable risk-benefit balance.

©Prescrire January 2010

Source: "Célécoxib : basses de prix, mais toujours là... hélas ! (suite)" Rev Prescrire 2009; 29 (314): 894.