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Feature Influenza Treatment

Will Tamiflu recommendations change this winter?

BMJ 2014; 349 doi: (Published 27 November 2014) Cite this as: BMJ 2014;349:g6742
  1. Andrew Jack, head of aggregation, Financial Times, London, UK
  1. andrew.jack{at}

Andrew Jack reports on renewed pressure to remove the antiviral drug oseltamivir from the World Health Organization’s powerful list of essential medicines

The World Health Organization is at the centre of a fresh debate on whether it should remove an antiviral drug from its influential list of recommended medicines, following a growing number of studies scrutinising the medicine’s value in treating influenza.

Members of the Cochrane collaboration have called for oseltamivir (Tamiflu) to be taken off WHO’s essential medicines list, a document of more than 300 drugs considered necessary to meet basic healthcare standards. It was first added in 2009, the year the H1N1 pandemic flu strain was identified.1

Chris Del Mar, professor of public health at Bond University in Australia and one of the Cochrane authors, said: “Oseltamivir was included at a time when it looked as though it was effective and it seemed prudent to planners to stockpile.”

His comments come after the publication of an update to the Cochrane review of clinical trials of oseltamivir and another neuraminidase inhibitor, zanamivir.2 Their work followed more than four years of efforts by the researchers and The BMJ to obtain raw trial data from drug companies and to track down submissions to regulators made around the world ( The Cochrane authors concluded, on the basis of a meta-analysis of 46 trials covering 24 000 patients, including data not previously made public, that the drugs shortened symptoms in seasonal influenza cases by less than a day and did not reduce the number of hospital admissions.

However, the PRIDE Consortium, …

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