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Prescrire publishes its annual update of drugs to avoid, in the name of better patient care

  DRUGS TO AVOID - 2021 UPDATE  For the ninth consecutive year, independent French medical journal Prescrire has published its annual update of drugs to avoid. The goal is to make it easier to choose high-quality care, and to prevent disproportionate harm to patients

Médicaments à écarter


  • Prescrire’s assessment of a drug’s harm-benefit balance in a given situation reflects a rigourous procedure based on: a systematic and reproducible literature search; patient-relevant outcomes; prioritisation of the supporting data according to strength of evidence; comparison with standard treatment (if one exists); weighing the adverse effects, including the uncertainties and the gaps in knowledge surrounding them.
  • This annual review of drugs to avoid covers all the drugs examined by Prescrire between 2010 and 2020 that are authorised in the European Union or in France. We identified 112 drugs (93 of which are marketed in France) that are more harmful than beneficial in all their approved indications (with rare exceptions explained in a footnote).
  • In most cases, when drug therapy appears to be the best course of action, other drugs with a better harm-benefit balance are available. 
  • Even for patients with a serious condition, who have exhausted all other treatment options, there is no justification for exposing them to drugs with major risks but no proven efficacy. It is sometimes acceptable to test these drugs in clinical trials, but patients must be informed of the uncertainties over their harm-benefit balance as well as the trial’s objectives. For patients who choose not to take part in a clinical trial, appropriate support and symptomatic care should be implemented when there are no effective treatments for improving the prognosis or quality of life.

©Prescrire 1 February 2021

Source: "Towards better patient care: drugs to avoid in 2021" Prescrire International 2021; 30 (223): 51-1 - 51-10. Free.

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For more information:

"Drugs to avoid: a reliable,
rigorous and independent
(February 2021)

"Drugs to avoid: main
changes in the 2021update"
(February 2021)

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