Why are ‘medicines to avoid’ allowed to stay in circulation in France?

French medical review Prescrire has published its tenth annual list of medicines that should be avoided - 89 of which are still available

89 medicines which Prescrire says should be avoided are still available in France
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Following your article about medicines to avoid in 2022, I was wondering: will they still be in circulation from now on and if so, why?

The independent not-for-profit medical publication Prescrire has published its tenth annual list of medicines which French healthcare professionals should avoid.

Read more:‘Medicines to avoid in 2022’ list published by French medical review

This may be because the medicines in question present too great a risk in terms of the side effects they can cause, or because new drugs with a more favourable benefit-risk ratio have been discovered. Prescrire also advises against drugs whose efficacy is not proven.

Of the 105 products that Prescrire analysed between 2010 and 2021 which have now been described as being “more dangerous than useful,” 89 are still available in France.

This is because Prescrire describes its annual review as a list of “medicines to eliminate in order to offer better care,” and not a list of medicines which must immediately be eliminated because of the risks they pose.

The aim is, rather, to guide healthcare professionals towards better quality medicines.

In the introduction to its yearly review, Prescrire writes that “the objective is to bring healthcare professionals, and therefore patients, information which is clear, concise, reliable and up to date, independent from commercial or corporate conflicts of interest.

“The information which we publish aims to attract the attention of healthcare workers and patients, regarding the medicines which are better avoided and for which there are often alternatives,” Prescrire spokesman Pierre Chirac told The Connexion.

“The majority of these medicines will remain on the market for a long time, which is why we recommend that professionals and patients discuss them together,” he added.

Prescrire’s report adds that: “Typically, when a medicinal treatment is advisable, other options have a better benefit-risks balance than the medicines which should be avoided. And in some situations, the wisest option is to not use any medicine at all.

“The use of these medicines is sometimes acceptable in the context of a clinical trial, provided that the patients understand any uncertainties surrounding the benefit-risk balance.”

All of the medicines referenced in the list are available either in France or in other EU countries.

Prescrire’s report includes some common cold and flu medicines, as well as three drugs – Galvus, Januvia and Onglyza – which are used to manage Type 2 diabetes.

“From a patient perspective, how is it justifiable to expose people to medicines which cause more undesirable side effects than others in the same pharmacological group, or which have a similar efficacy?” Prescrire’s report asks.

“In addition to the active work of healthcare professionals to remove from their treatment arsenal these medicines which companies persist in putting on the market, health authorities should also take concrete measures which protect patients and encourage professionals and patients to move towards treatments with a more favourable benefit-risk ratio.”

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