Prescrire's assessment of a drug's harm-benefit balance in a given situation is underpinned by a rigorous procedure based on: a systematic and reproducible literature search; analysis of data on patient-relevant outcomes; prioritisation of the highest-level evidence; comparison with standard treatment, if one exists; and appraisal of the drug's known, foreseeable and suspected adverse effects.
Our 2026 review of drugs to avoid covers all the drugs examined by Prescrire between 2010 and 2025 that are authorised in the European Union or in France. It consists of 108 drugs that have an unfavourable harm-benefit balance in all the clinical situations in which they are authorised.
For the patients concerned, when drug therapy appears to be the best course of action, other options with a better harm-benefit balance are available. And in some situations, the most prudent option is to forgo drug therapy.
Even when seriously ill patients have exhausted all other treatment options, there is no justification for exposing them to a drug with serious adverse effects when it has no demonstrated clinical efficacy. It may be acceptable to test such a drug in clinical trials, provided that the patients concerned are made fully aware of the uncertainties surrounding the drug's harm-benefit balance and the reasons for its continued evaluation, through discussions tailored to the patient's level of understanding. When such patients choose not to take part in a clinical trial, appropriate support and symptomatic care are called for, to mitigate the absence of any effective drug-based options capable of improving their prognosis or quality of life.
For more about this year's update:
Drugs to avoid: a reliable, rigorous, independent analysis HERE
Drugs to avoid: main changes in the 2026 update HERE
©Prescrire 1 February 2026
Source: "Towards better patient care: drugs to avoid in 2026" Prescrire Int 2026; 35 (278): 54-1 - 54-12. FREE.
|
Enjoy full access to Prescrire International, and support independent information
|