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Feature Antiviral Drugs

Tamiflu: “a nice little earner”

BMJ 2014; 348 doi: (Published 09 April 2014) Cite this as: BMJ 2014;348:g2524
  1. Andrew Jack, deputy analysis editor
  1. 1Financial Times, London, UK
  1. andrew.jack{at}

Is the story of oseltamivir, and similar antiviral drugs, a classic one of big pharma greed? Andrew Jack finds a more nuanced reality

Viewed with hindsight, the story of flu antiviral drugs seems to be a classic story of “big pharma” greed. On the back of media hype and unfulfilled fears, a new medicine backed by only modest clinical data became a “blockbuster” generating billions of dollars for its producer. The reality is more nuanced, and the tale could easily instead have been a commercial and public health nightmare.

There is no doubt that Roche, the Swiss based pharmaceutical group, and its shareholders, have done very well from oseltamivir (Tamiflu). The drug became one of the most widely recognised medicines in the world as concern grew about a new flu pandemic in the middle of the previous decade.

As one City financial analyst puts it: “Tamiflu was a nice little earner. It reflected opportunistic action by a multinational corporation, which was able to be a little bit sharper in its marketing practices than you could now, given the debates over the disclosure of clinical data and how effective the drug was.”

Yet other related antiviral drugs in the same class of neuraminidase inhibitors failed to take off; oseltamivir itself was nearly a flop; public health pressures capped its pricing; and policy makers and the drug company itself struggled with scant clinical information on efficacy. Its success was linked to the unprecedented purchase of such a large volume of drugs to prepare for a future pandemic threat from a still poorly understood infectious disease.

Unlikely success

Since its launch in 1999, oseltamivir has generated cumulative sales in excess of $18bn (£11bn; €13bn) for Roche. Half of the total expenditure was by governments and companies around the world for stockpiles for pandemic preparations. The …

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