Annual vaccination is the best strategy to prevent influenza. However, as the vaccine industry continues to work towards developing a Universal Flu Vaccine, it is important to consider the available treatment options and subsequently to make sure that the public is kept up-to-date with the options available to them. Last week, the UK media was alight with claims that the government had wasted over £500 million on stockpiling Tamiflu (oseltamivir) in 2006, in reponse to fears that arose at the time of a repeat of a 1918 style flu pandemic. These fears stemmed from concerns over the high death rate of H1N1 in Asia- as high as 40%. Along with many other developed countries, the UK reacted by stockpiling in a “form of a class of drugs known as neuraminidase inhibitors. Tamiflu is the most useful of these because it comes as capsules which can be taken orally, and are easily shipped and stored.” (Robert Dingwell) During the 2009 H1N1 (Swine Flu) pandemic, these supplies were drawn down and have since only been partially replenished. Since 2009, Tamiflu has been used to treat influenza, primarily in high-risk groups.
The Tamiflu debate plays on the anxiety held within the policy community that public expectations of Tamiflu would exceed what it could actually deliver. Re-ignited by the release of a paper in the British Medical Journal (BMJ) by the Cochrane Collabroation earlier this month, which aimed: “to describe the potential benefits and harms of oseltamivir by reviewing all clinical study reports (or similar document when no clinical study report exists) of randomised placebo controlled trials and regulatory comments (“regulatory information”).” Read the full report here.
What is key to this debate is the experience of Tamiflu in 2009- was it effective? Robert Dingwell discusses this question in his article Tamiflu and the Ethics of the British Medical Journal released on Social Science Space yesterday.
“So what was the experience with Tamiflu in 2009? Coincidentally, a study of the use of this class of drugs— mostly Tamiflu use — was published in the respected Lancet Respiratory Medicine two weeks previously. This found that, in clinical use with almost 30,000 patients world-wide during the 2009 pandemic, the drug did rather more than the symptom reductions claimed from the manufacturer’s trials: it also reduced the death rate among patients who were ill enough to need hospital treatment by 20 percent overall — and by as much as 50% among those who started anti-viral therapy within 48 hours. Even where the therapy started later, there was still evidence of benefit. Would you have known this if you were not a regular reader of Lancet Respiratory Medicine? There was a press release but the journalists who were quick to run a bad news story two weeks later did not follow this up. Indeed, you could read virtually all the coverage of the BMJ paper without being told that an equally serious study had only just published contradictory results.” Robert Dingwell
You can read Robert’s full article here.
The Lancet report referenced by Robert Dingwell in this passage entitled Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data can be found here.
Personally, as a marketer not a scientist, what is of particular interest in Robert’s article is the question of the ethics of BMJ. The vaccine industry has in recent years been plagued with a negative image in the media. This image has contributed to a dangerous public misconception that vaccines are dangerous to our health. Is the Tamiflu debate another example of the media promoting misinformation to the public?