Cochrane review questions effectiveness of neuraminidase inhibitors

The Department of Health for England has wasted more than £500m (€600m; $830m) on stockpiling neuraminidase inhibitors to use in the event of a flu pandemic, and it should not replace them when they expire, concludes the first complete systematic review of the drugs by the Cochrane Collaboration.1 2 3

For the first time the collaboration was able to look at complete data from all trials conducted on oseltamivir (marketed as Tamiflu) and zanamivir (Relenza) by their respective manufacturers, Roche and GlaxoSmithKline, after a four and a half year battle by the reviewers and The BMJ to gain access to the full data. GSK was the first to provide the information, doing so early last year, and by September 2013 Roche had also complied.4

The review looked at 46 trials (20 on oseltamivir and 26 on zanamivir), involving more than 24 000 people and reported in more than 160 000 pages of regulatory documents. Previous Cochrane reviews and appraisals by most regulatory authorities, including the European Medicines Agency, have had access to only a limited amount of the data made available by the drug manufacturers.

Recommendations based on these limited data have prompted governments around the world to stockpile oseltamivir in the belief the drug …