Observations Reality Check

Was the flu drug zanamivir a breakthrough or money for old rope?

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g3611 (Published 02 June 2014) Cite this as: BMJ 2014;348:g3611
  1. Ray Moynihan, author, journalist, and senior research fellow, Bond University, Australia
  1. RayMoynihan{at}bond.edu.au

While Relenza’s benefits are modest at best, its story would make a great Hollywood blockbuster

A drug company executive hailed it as “one of the greatest discoveries of the 20th century” and an Australian politician predicted two decades ago it might be a “breakthrough as significant as penicillin.” The Independent on Sunday in the UK ran a front page story declaring “a cure for flu that actually works,” and Australian tabloids quoted a patient saying that within 24 hours of taking it, “I was completely cured.” Given the sober findings of the recent Cochrane review of the drug,1 and the resources invested in pandemic stockpiles, all this misleading hype about zanamivir (Relenza) now seems obscene. Yet, inside the offices of the world’s most powerful drug regulator, a young biostatistician had concluded 15 years ago that the drug’s benefits were extremely limited. His findings back in 1999 would ignite the fury of one of the world’s most powerful drug companies and set the scene for a case study in failed regulation.

Later overshadowed by its more famous cousin, oseltamivir (Tamiflu), zanamivir was the first in this new class of anti-flu drug, the neuraminidase inhibitors. In …

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