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• Decline in vigilance: worldwide epidemic!

Something fishy is going on here! In an increasingly interconnected world, we all need an annual April "booster shot", to take a good, hard look at our perception of information.

 APRIL FOOL'S !  But, seriously now, the plan for the worldwide Agency for Drug Reconciliation published in Prescrire's April issue could very nearly be true...

In order to harmonise the rules governing market access for new drugs, the medicines agencies of the wealthiest countries and three pharmaceutical industry trade associations, acting together within the International Conference on Harmonisation (ICH), have imposed their criteria for evaluation of new drugs on the entire world (1). One can imagine that in a not-so-distant future the "globalisation" of the drugs market will indeed lead to the creation of a worldwide medicines agency.

And as for getting by with just one clinical trial in order to grant a marketing authorisation (MA), unfortunately this is all to often the case already... And experience shows that this trial is not always of sufficient methodological quality to reveal the drug's true interest for patients. 

30 years of "fishy business" in April
The traditional April prank by Prescrire's editors serves as an annual "booster shot" to remind us all that in the serious business of medical information, it pays to exercise critical judgement at all times.

In April 1983 Prescrire's "special correspondent" revealed to enthralled readers the enormous interest of protryptophane in the treatment of acute senility... And ever since, the experiment has been repeated yearly in La revue Prescrire's April issue.

In 2003 Prescrire's "April fish" (as the seasonal pranks are known in France) even made it into the English edition, Prescrire International. It's included below, in a sampling of Prescrire's yearly "Poissons d'avril".

Greatest hits from Prescrire's annual "Poisson d'avril" prank

©Prescrire 1 April 2013

1- Prescrire Editorial Staff "ICH: an exclusive club of drug regulatory agencies and drug companies imposing its rules on the rest of the world" Prescrire Int 2010; 19 (108): 183-186.

ADR: a new
global phenomenon,
thanks to the ICH