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

• A new drug treatment makes headlines in France: olanzapine + topiramate (Obéfix°), maintains ideal weight without risk (1 April 2012)
  "La Revue Prescrire has revealed unbelievable new results that will be welcome reading for medical professionals and patients alike. ..." 
  "Olanzapine + topiramate (Obéfix°)" Rev Prescrire 2012; 33 (342: 248-251. (pdf in French, free)
> Online news item in English (April 2012). Free

• Doing away with adverse effects (1 April 2011) 
  "A modest proposal from the Informal Collusion for Hypermedicamentation (ICH)...." 
  "En finir avec les effets indésirables" Rev Prescrire 2011 ; 31 (330): 295. (pdf in French, free)
  
  
• Prostate transplants: too many deaths (1 April 2009)
  "In practice, it is best not to encourage patients to undergo a prostate transplant. And to read Prescrire with a critical eye... "
  "Greffes de prostate : trop de décès" Rev Prescrire 2009 ; 29 (306): 268. (pdf in French, free)
   
• Dextrodénafil // lévoxétine (Libidossil°) (1 April 2006)
  "Drug-based dissociation of erectile dysfunction: a double me-two fantasy"
  "dextrodénafil // lévoxétine (Libidossil°)" Rev Prescrire 2006 ; 26 (271) : 251. (pdf in French, free)

•  IN ENGLISH  Tour de France: ads in the saddle! (1 April 2003)
  "In case Credit Lyonnais pulls out of Tour de France sponsorship, negotiations with the French pharmaceutical federation are nearing completion... Companies manufacturing growth hormones and erythropoietin, have opted for the spotted jersey for the best climber..."
  "Tour de France: ads in the saddle!" Prescrire Int 2003 ; 11 (66) : 307. (pdf, free)

• The 2001 "Golden Microphone" awards
  for the pharmaceutical industry (1 April 2001)
  "The drug industry shows that it knows how to show its gratitude to deserving "opinion leaders"..." 
  "Les micros d'Or 2001 de l'industrie pharmaceutique"  Rev Prescrire 2001 ; 21 (216) : 307. (pdf in French, free)
  
  
• Diffunase° (1 April 2000)
  "Prevention of stress, of sexual dysfunction, of insomnia, primal urges, bulimia, etc. All by a very novel means of administration: air travel."
  "Gamme Diffunase°, n'importe quoi !"  Rev Prescrire 2000 ; 20 (205) : 266-268. (pdf in French, free)
  
  
• The French medicines agency and the Y2K bug (1 April 1999)
  "For the most difficult months, until approximately 1 April 2000, we will be using an amazing team of carrier pigeons that was recently retired from the armed services. I would like to particularly thank the National Pharmaceutical Association which once again provided financial assistance..."
  "L'Agence française du médicament et le bogue de l'an 2000" Rev Prescrire 1999 ; 19 (194) : 308. (pdf in French, free)
  
  
• A computerised medical information system in France? (1 April 1997)
  "A confidential report by the Ministries of Health and Finance contains a proposal for a mandatory computerised medical identification system, in the form of an unremovable computerised bracelet to be worn by all beneficiaries of the national health insurance system..."  
  "Un carnet de santé informatisé en France ?" Rev Prescrire 1997; 17 (172) : 284 - 285 et 308. (pdf in French, free)
  
  
• Panaceum° tablets (1 April 1984)
  "All the results are unanimous, just a single 5 mg dose is enough to cure the great majority of illnesses. The huge advantage for us prescribers is that there is no need for a precise diagnosis. As soon as we suspect some disorder, major or minor, no matter what it involves, the prescription is the same..."
  "Panaceum° comprimés" Rev Prescrire 1984 ; 4  (34) : 2. (pdf in French, free)
  "Panaceum° d'avril" Rev Prescrire 1984 ; 4  (35) : II. (pdf in French, free)
  
  
• Kwajalumpur. 3rd Symposium of the International Federation of Experimental Gerontopathology: protryptophane can cure senility (1 April 1983)
  "The press must be ever alert in order to satisfy readers' thirst for news..."
  "Kwajalumpur. Troisième symposium de la Féderation Internationale de Gérontopathologie Expérimentale : le protryptophane peut guérir la sénilité" Rev Prescrire 1983 ; 3 (24) : 13 - 14. (pdf in French, free)
  

©Prescrire 1 April 2013

Reference:
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.