Month after month for the past 35 years, the French non-profit journal Prescrire has helped tens of thousands of healthcare professionals to make the best choices from amongst the available therapeutic options.
The August 2015 special issue of Prescrire's French edition explores just what constitutes decisive progress for the benefit of patients.
Genuine therapeutic advances are in the minority, and can be difficult to spot. Certain advances seem "obvious", when they increase survival time without a disproportionate decrease in quality of life, or when they reduce suffering, or allow complications or serious adverse effects to be avoided. This was the case for the first antiretroviral drugs, and then the first "triple therapy" combinations to treat patients infected with HIV. These advances were the result of significant public investment in research. The advances which have benefited patients suffering from certain rare diseases are also the result of strong public will, and of regulation favourable to progress.
Other advances are less obvious, but useful, for example when they aim to better protect people: adding a child-proof cap to the packaging of a dangerous drug to decrease the risk of accidental ingestion by a child; safety devices to reduce the risk of needlestick injuries in healthcare professionals. These advances are the result of teamwork at drug and device companies or at regulatory agencies who give thought to improving the way medicines are used.
Still other advances, involving older drugs that are no longer protected by a patent, are almost never highlighted, with a few exceptions. Evaluating these drugs, optimising their dosages, looking for new forms that are better tolerated, inventing better-adapted packaging, can also be sources of genuine progress for patients.
©Prescrire 1 August 2015
"Des progrès décisifs au profit des patients" Rev Prescrire 2015; 35 (382). View the table of contents (Free, in French)