8 ms·

Tamiflu: Millions wasted on flu drug, claims major report

71 points by nairteashop 13y ago

motbob 13y ago
The article does a bad job of explaining what the Cochrane report finds to be flawed about the clinical trials.
- gwern 13y ago
  It's hard to tell because the latest version of "Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children" doesn't seem to be out (just the 2012) version, and the OP's citation breaks on the wiley site! Even Cochrane's own materials aren't very clear. The best seems to be http://www.cochrane.org/features/neuraminidase-inhibitors-preventing-and-treating-influenza-healthy-adults-and-children http://www.cochrane.org/features/neuraminidase-inhibitors-pr... "Questions about the accuracy of these claims and the efficacy of both preparations prompted an international team of researchers, led by Dr Tom Jefferson, a Cochrane Review author and independent epidemiologist based in Rome, Italy, to examine newly available evidence and amalgamate two previously published Cochrane Reviews focusing on the efficacy of these interventions into one comprehensive, updated review, published in the January 2012 issue of The Cochrane Library. In carrying out this research, the Cochrane team was reluctant to focus their efforts on published trial reports available in scientific journals, because while many trials have been conducted around the world, only a few have been published. “We identified that a large number of studies, including data from 60% of the people who have been involved in randomised, placebo-controlled phase III treatment trials of oseltamivir, have never been published. This includes the biggest treatment trial ever undertaken on oseltamivir that on its own included just over 1,400 people of all ages,” noted Jefferson. "We are concerned that these data remain unavailable for scrutiny by the scientific community." Following a public pledge by the manufacturer of oseltamivir, Roche, to make full study reports available to scientific investigators, the Cochrane team decided to focus instead on manufacturers’ clinical study reports (typically submitted to regulators) and regulators’ comments. They called reports and comments “regulatory information”. Availability of documents generated by national and regional regulatory bodies during licensing processes in the UK, USA, continental Europe and Japan, along with partial trial reports from the manufacturer of oseltamivir, Roche, and from the European regulator European Medicines Agency (EMA), enabled the researchers to verify information from the trials. When the team compared published data with the more complete unpublished trial records, they found apparent inaccuracies in the published record of the trials. For example, while unpublished trial reports mentioned serious adverse events (some even classified as possibly related to oseltamivir), one of the two most cited publications makes no mention of such effects, and the other states “... there were no drug-related serious adverse events”. Having pieced together information from more than 16,000 pages of clinical trial data and documents used in the process of licensing oseltamivir, the Cochrane team raises critical questions about how well the drug works, as well as about its reported safety profile. While the drug did reduce the time to first alleviation of symptoms by an average of 21 hours, it did not reduce the number of people who went on to need hospital treatment. Results from the reanalysis of data also raise questions about how the drug works as an influenza virus inhibitor."
- nairteashop 13y ago
  I believe this is the news release from Cochrane that the BBC article is based on. There is more detail there on why they believe Tamiflu is ineffective: http://www.cochrane.org/features/tamiflu-relenza-how-effective-are-they http://www.cochrane.org/features/tamiflu-relenza-how-effecti...
turnip1979 13y ago
I was prescribed Tamiflu once a few years ago and wow .. what a weird drug. My memory might be off but I think it is supposed to reduce the length of the flu by just 2-3 days. And it has to be taken within a short period of getting the flu. Didn't feel it was worth it.
- ceejayoz 13y ago
  As the parent of twins born premature at 26 weeks (missed the third trimester by a day!), 2-3 day reduction can be a lifesaver for some vulnerable populations. Not saying anything about Tamiflu's effectiveness, just that 2-3 days can be a lot.
- eco 13y ago
  It was always my understanding that Tamiflu was more for people for whom contracting influenza was life threatening. Not for regular people to experience a shorter flu. This report is pretty damning, regardless.
  - migrantgeek 13y ago
    I'm sure it was initially created for that purpose however as soon as demand tapers off they'll being to seek new customers.
  - karmajunkie 13y ago
    I've taken it in the past when my son tested positive for flu, but before I've shown symptoms. I've yet to come down with it under those circumstances. Of course, its impossible to say for sure whether I'd have gotten the flu otherwise, but anecdotally I believe it was successful prophylaxis.
- keithg 13y ago
  I had the flu last month (actually tested positive), and the Tamiflu seemed to get me back on my feet pretty quickly. At the same time, my wife took a prophylactic dose and she did not get the flu. Similarly, 3 years ago, both of my sons and my wife tested positive, all saw improvements within 24 hours of taking it. I took a prophylactic dose that time and did not get the flu. Anecdotal, I guess, but I would take it again in similar circumstances.
deleted 13y ago
[deleted]
ceejayoz 13y ago
"Paracetamol" is acetaminophen (Tylenol) in the US, if anyone's wondering.
- rdl 13y ago
  Tangentially (since this article is boring, I don't think it's unreasonable): acetaminophen is one of the commonly-used drugs which I think is most dangerous. Aside from liver-damage-suicide-through-overdose, and accidental overdose, there are a common conditions where you'd want headache relief (hangover, dehydration, ...) where the liver-damage risk for a normal dose is substantial (and people commonly take 2-3x the normal dose if they have "a bad headache, as more is obviously better...). Another huge sin of the US drug war is mixing likely-to-be-abused painkillers like codeine with acetaminophen to lower their "abuse potential" -- but, with junkies not being rational, it leads to abusers destroying their livers.
  - ekianjo 13y ago
    Indeed. For symptomatic relief, Aspirin is usually a better option at low doses (as long as your stomach does not suffer too much from it, since it causes stomach bleeding).
    - balls187 13y ago
      Perhaps this goes without saying but, I want to warn against taking medical opinion/advice that is found on the internet, especially from a forum that mostly revolves to Software, Tech, and Startups. > Aspirin is usually a better option at low doses (as long as your stomach does not suffer too much from it, since it causes stomach bleeding). http://en.wikipedia.org/wiki/Reye_syndrome http://en.wikipedia.org/wiki/Reye_syndrome
      - mentalhealth 13y ago
        > I want to warn against taking medical opinion/advice that is found on the internet This is excellent advice, but the scaremongering re Reye's is unnecessary. Many more lives & livers would be saved by people ceasing their use of acetaminophen than would be risked by people switching to aspirin.
Elepsis 13y ago
Worth pointing out to American readers that paracetamol is known in the U.S. as acetaminophen, the active ingredient in (most notably) Tylenol.
ekianjo 13y ago
During the H1N1 craze in 2009 (I remember it very well), governments from all countries around the world were fighting to get enough stock of Tamiflu in case of a global Pandemic. Even at that time I thought this was ridiculous, not just because the risk of Pandemic was overblown (and the media played a huge part in it), but also because there had been no clinical trial suggesting that Tamiflu would be working against that particular strain of H1N1. Pure waste of taxpayers money by uninformed politicians reacting to panic.
- j2d3 13y ago
  Tamiflu is made by Gilead. Donald Rumsfeld was on the board. Mexico (among other countries) borrowed millions from the world bank to buy Tamiflu during the H1N1 craze. http://www.nybooks.com/articles/archives/2011/dec/22/world-bank-and-money-flu/ http://www.nybooks.com/articles/archives/2011/dec/22/world-b... I say all this to suggest that it's not a waste of taxpayer money by uninformed politicians... no - the politicians are very well informed.
  - ekianjo 13y ago
    That's why it would be appropriate to have all politicians disclose their conflicts of interests.
    - tommu 13y ago
      I would rather that they simply were not allowed conflicts of interest during and after office. No joining companies lobbying for the industry you were supposedly regulating when in office. ETC.
      - icelancer 13y ago
        How can you enforce the "after office" clause?
        tommu 13y ago
lvevjo 13y ago
Cochrane is very good at what they do. This kind of systematic review is the highest standard of evidence when it comes to medical research. It's worth checking out some of their other reviews: http://www.cochrane.org/cochrane-reviews/top http://www.cochrane.org/cochrane-reviews/top Note that these are abstracts of the full reviews (which they charge for access). On a side note, meta-research deserves more funding! http://blog.givewell.org/2013/06/06/meta-research-update/ http://blog.givewell.org/2013/06/06/meta-research-update/ edit: I linked to the wrong review before (not the one under discussion), so I edited that out. As gwern mentions in another comment, the link is broken in the BBC article. nairteashop found a different news release which seems to be the right link: http://www.cochrane.org/features/tamiflu-relenza-how-effective-are-they http://www.cochrane.org/features/tamiflu-relenza-how-effecti...
- sithu 13y ago
  I agree with most of what you've said, except that I think the recent enthusiasm for doing systematic reviews + meta-analysis is way overblown. What really needs funding is novel high-risk/high-reward research that isn't necessarily supported by precedent data.
microjesus 13y ago
This is like Vitamin C. No one believes me that it's been debunked. My god, the things that marketing can sell which are of no use.
- smtddr 13y ago
  I dunno about that. Those Emergen-C 1000mg Vitamin C powder packs work wonders for me. If it's been debunked then I got some kinda crazy placebo effect going on.
  - js2 13y ago
    8.1. Cold and Flu According to meta-analyses on the topic assessing doses of 200mg vitamin C or more, vitamin C has failed to reduce the frequency of colds in the normal population but was successful in reducing the duration of colds (on average 8-14%);[149][145] when looking at studies investigating extreme physical stress (marathoners and skiiers), the risk of getting a cold was halved (which has been noted in past meta-analyses[144]) http://examine.com/supplements/Vitamin+C/#summary8-0 http://examine.com/supplements/Vitamin+C/#summary8-0
    - smtddr 13y ago
      That's actually in line with how I use it. Definitely not a marathoner/skiier but I work out about an hour a day and I never expect Vitamin-C to prevent colds. I only take it after 2 to 3 day of sensing an incoming cold.
      - vixen99 13y ago
        I remember a recent study found that vitamin C had no effect on the period or severity of a cold but zinc did. Seems to be confirmed by this :- https://www.ncbi.nlm.nih.gov/pubmed/15496046 https://www.ncbi.nlm.nih.gov/pubmed/15496046
- mmariani 13y ago
  Did you even read the article? Marketing had nothing to do with the "success" of this drug. Good and old FUD did. The drug was sold directly from Roche to governments. Typical HN bias, it's all marketing's fault. Next time just follow the money.
tptacek 13y ago
I thought it was pretty well-known that Tamiflu wasn't particularly effective, and that the UK NHS had already been criticized for stockpiling it.
- crazytony 13y ago
  this is the lingering problem: it's terribly ineffective if you go to the doctor with flu symptoms. Seriously. Tamiflu blocks the channels used to multiply the influenza virus. By the time you recognise you have the flu Tamiflu looks to be completely and utterly ineffective. I haven't seen a societal study to say it's better or worse as a group of individuals. I would be really interested in that.
deleted 13y ago
[deleted]
willvarfar 13y ago
In Sweden, almost everyone was vaccinated with Pandemrix http://en.wikipedia.org/wiki/Pandemrix http://en.wikipedia.org/wiki/Pandemrix I think this is not the same exact drug as Tamiflu, but the parallels - mass vaccination etc - are worth drawing. The scary thing about Pandemrix is that some people - mostly children and young adults - immediately got narcolepsy http://en.wikipedia.org/wiki/Narcolepsy http://en.wikipedia.org/wiki/Narcolepsy Now the various investigations have all said they can find no link between narcolepsy and Pandemrix, and yet they don't really explain the suddenness of it all. Seems a hell of a coincidence. Narcolepsy is not some silly little "sleep disorder". This was really brought home to me - literally - by knowing someone who's child got it hours after their Pandemrix jab =( The micro-problem here is the Swedish state trying to avoid paying for care (its untreatable, as I understand it) and all that wrangling about taking responsibility. I think most parents of suffers are really out to share around the burden of responsibility, rather than caring so much about the costs of care. The macro-problem is convincing people that the next time we are told to go get a jab, we should :( Here's Penn & Teller talking about Vaccines: https://www.youtube.com/watch?v=RfdZTZQvuCo https://www.youtube.com/watch?v=RfdZTZQvuCo Science isn't going to win over my wife as easily as all that. And I am very divided myself, however rational I try and be.
- beedogs 13y ago
  Tamiflu isn't a vaccine; it's an antiviral. You take it when you already have flu symptoms.
  - willvarfar 13y ago
    The parallel was not the drug, it was the government program and the money.
bananas 13y ago
I got given some of this in the UK when I had the sniffles during the panic. I didn't actually go to the doctors for that problem. Ultimately I didn't take them and I suspect that most people didn't or they were disposed off after the discard date. Some people walked off with a fucking huge pile of cash after that one...
robmcm 13y ago
It's a bit like saying we wasted millions of preparing for heavy snow in the UK this year as we got none. If H1N1 or derivatives caused a serious pandemic I would much rather have some Tamiflu than not, even if it's effectiveness varied for patient to patient. It's easy to say money was wasted with hindsight.
- kitd 13y ago
  I don't think your analysis is correct. They're not saying that the money is wasted because we haven't had a flu outbreak. They are saying that, if there was one, Tamiflu would be as useful as paracetamol. It would be like (in your analogy) someone claiming that the snow clearing equipment bought was known to be faulty or not work in cold conditions. In that case, saying the money was wasted would be justifiable. I don't have an answer, other than the observation that there are too many cases these days where public health and commerce don't work well together.
  - robmcm 13y ago
    > I would much rather have some Tamiflu than not, even if it's effectiveness varied for patient to patient. At the time Tamiflu was believed to work well, and must have had studies that backed this up (otherwise it wouldn't have got past NICE). If it is in fact no better than paracetamol then with hindsight you could argue it was a mistake to stockpile, however I was reassured that my government had prepared, which in itself could have avoided some additional panic and bad press.
bencollier49 13y ago
Is this another casualty of the "selective publication" of results performed by pharma companies?
tokenadult 13y ago
The follow-up article on this report[1] from Science-Based Medicine provides more details and good perspective on the difficulty in general of studying the safety and effectiveness of new treatments of any kind for any condition. [1] http://www.sciencebasedmedicine.org/new-evidence-same-conclusion-tamiflu-only-modestly-useful-for-influenza/ http://www.sciencebasedmedicine.org/new-evidence-same-conclu...
gwern 13y ago
Fulltext: http://www.bmj.com/content/348/bmj.g2545 http://www.bmj.com/content/348/bmj.g2545

71 points by nairteashop 13y ago

motbob 13y ago

The article does a bad job of explaining what the Cochrane report finds to be flawed about the clinical trials.

gwern 13y ago
It's hard to tell because the latest version of "Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children" doesn't seem to be out (just the 2012) version, and the OP's citation breaks on the wiley site! Even Cochrane's own materials aren't very clear. The best seems to be http://www.cochrane.org/features/neuraminidase-inhibitors-preventing-and-treating-influenza-healthy-adults-and-children http://www.cochrane.org/features/neuraminidase-inhibitors-pr... "Questions about the accuracy of these claims and the efficacy of both preparations prompted an international team of researchers, led by Dr Tom Jefferson, a Cochrane Review author and independent epidemiologist based in Rome, Italy, to examine newly available evidence and amalgamate two previously published Cochrane Reviews focusing on the efficacy of these interventions into one comprehensive, updated review, published in the January 2012 issue of The Cochrane Library. In carrying out this research, the Cochrane team was reluctant to focus their efforts on published trial reports available in scientific journals, because while many trials have been conducted around the world, only a few have been published. “We identified that a large number of studies, including data from 60% of the people who have been involved in randomised, placebo-controlled phase III treatment trials of oseltamivir, have never been published. This includes the biggest treatment trial ever undertaken on oseltamivir that on its own included just over 1,400 people of all ages,” noted Jefferson. "We are concerned that these data remain unavailable for scrutiny by the scientific community." Following a public pledge by the manufacturer of oseltamivir, Roche, to make full study reports available to scientific investigators, the Cochrane team decided to focus instead on manufacturers’ clinical study reports (typically submitted to regulators) and regulators’ comments. They called reports and comments “regulatory information”. Availability of documents generated by national and regional regulatory bodies during licensing processes in the UK, USA, continental Europe and Japan, along with partial trial reports from the manufacturer of oseltamivir, Roche, and from the European regulator European Medicines Agency (EMA), enabled the researchers to verify information from the trials. When the team compared published data with the more complete unpublished trial records, they found apparent inaccuracies in the published record of the trials. For example, while unpublished trial reports mentioned serious adverse events (some even classified as possibly related to oseltamivir), one of the two most cited publications makes no mention of such effects, and the other states “... there were no drug-related serious adverse events”. Having pieced together information from more than 16,000 pages of clinical trial data and documents used in the process of licensing oseltamivir, the Cochrane team raises critical questions about how well the drug works, as well as about its reported safety profile. While the drug did reduce the time to first alleviation of symptoms by an average of 21 hours, it did not reduce the number of people who went on to need hospital treatment. Results from the reanalysis of data also raise questions about how the drug works as an influenza virus inhibitor."
nairteashop 13y ago
I believe this is the news release from Cochrane that the BBC article is based on. There is more detail there on why they believe Tamiflu is ineffective: http://www.cochrane.org/features/tamiflu-relenza-how-effective-are-they http://www.cochrane.org/features/tamiflu-relenza-how-effecti...

turnip1979 13y ago

I was prescribed Tamiflu once a few years ago and wow .. what a weird drug. My memory might be off but I think it is supposed to reduce the length of the flu by just 2-3 days. And it has to be taken within a short period of getting the flu. Didn't feel it was worth it.

ceejayoz 13y ago
As the parent of twins born premature at 26 weeks (missed the third trimester by a day!), 2-3 day reduction can be a lifesaver for some vulnerable populations. Not saying anything about Tamiflu's effectiveness, just that 2-3 days can be a lot.
eco 13y ago
It was always my understanding that Tamiflu was more for people for whom contracting influenza was life threatening. Not for regular people to experience a shorter flu. This report is pretty damning, regardless.
- migrantgeek 13y ago
  I'm sure it was initially created for that purpose however as soon as demand tapers off they'll being to seek new customers.
- karmajunkie 13y ago
  I've taken it in the past when my son tested positive for flu, but before I've shown symptoms. I've yet to come down with it under those circumstances. Of course, its impossible to say for sure whether I'd have gotten the flu otherwise, but anecdotally I believe it was successful prophylaxis.
keithg 13y ago
I had the flu last month (actually tested positive), and the Tamiflu seemed to get me back on my feet pretty quickly. At the same time, my wife took a prophylactic dose and she did not get the flu. Similarly, 3 years ago, both of my sons and my wife tested positive, all saw improvements within 24 hours of taking it. I took a prophylactic dose that time and did not get the flu. Anecdotal, I guess, but I would take it again in similar circumstances.

deleted 13y ago

[deleted]

ceejayoz 13y ago

"Paracetamol" is acetaminophen (Tylenol) in the US, if anyone's wondering.

rdl 13y ago
Tangentially (since this article is boring, I don't think it's unreasonable): acetaminophen is one of the commonly-used drugs which I think is most dangerous. Aside from liver-damage-suicide-through-overdose, and accidental overdose, there are a common conditions where you'd want headache relief (hangover, dehydration, ...) where the liver-damage risk for a normal dose is substantial (and people commonly take 2-3x the normal dose if they have "a bad headache, as more is obviously better...). Another huge sin of the US drug war is mixing likely-to-be-abused painkillers like codeine with acetaminophen to lower their "abuse potential" -- but, with junkies not being rational, it leads to abusers destroying their livers.
- ekianjo 13y ago
  Indeed. For symptomatic relief, Aspirin is usually a better option at low doses (as long as your stomach does not suffer too much from it, since it causes stomach bleeding).
  - balls187 13y ago
    Perhaps this goes without saying but, I want to warn against taking medical opinion/advice that is found on the internet, especially from a forum that mostly revolves to Software, Tech, and Startups. > Aspirin is usually a better option at low doses (as long as your stomach does not suffer too much from it, since it causes stomach bleeding). http://en.wikipedia.org/wiki/Reye_syndrome http://en.wikipedia.org/wiki/Reye_syndrome
    - mentalhealth 13y ago
      > I want to warn against taking medical opinion/advice that is found on the internet This is excellent advice, but the scaremongering re Reye's is unnecessary. Many more lives & livers would be saved by people ceasing their use of acetaminophen than would be risked by people switching to aspirin.

Elepsis 13y ago

Worth pointing out to American readers that paracetamol is known in the U.S. as acetaminophen, the active ingredient in (most notably) Tylenol.

ekianjo 13y ago

During the H1N1 craze in 2009 (I remember it very well), governments from all countries around the world were fighting to get enough stock of Tamiflu in case of a global Pandemic. Even at that time I thought this was ridiculous, not just because the risk of Pandemic was overblown (and the media played a huge part in it), but also because there had been no clinical trial suggesting that Tamiflu would be working against that particular strain of H1N1. Pure waste of taxpayers money by uninformed politicians reacting to panic.

j2d3 13y ago
Tamiflu is made by Gilead. Donald Rumsfeld was on the board. Mexico (among other countries) borrowed millions from the world bank to buy Tamiflu during the H1N1 craze. http://www.nybooks.com/articles/archives/2011/dec/22/world-bank-and-money-flu/ http://www.nybooks.com/articles/archives/2011/dec/22/world-b... I say all this to suggest that it's not a waste of taxpayer money by uninformed politicians... no - the politicians are very well informed.
- ekianjo 13y ago
  That's why it would be appropriate to have all politicians disclose their conflicts of interests.
  - tommu 13y ago
    I would rather that they simply were not allowed conflicts of interest during and after office. No joining companies lobbying for the industry you were supposedly regulating when in office. ETC.
    - icelancer 13y ago
      How can you enforce the "after office" clause?
      - tommu 13y ago

lvevjo 13y ago

Cochrane is very good at what they do. This kind of systematic review is the highest standard of evidence when it comes to medical research. It's worth checking out some of their other reviews: http://www.cochrane.org/cochrane-reviews/top http://www.cochrane.org/cochrane-reviews/top Note that these are abstracts of the full reviews (which they charge for access). On a side note, meta-research deserves more funding! http://blog.givewell.org/2013/06/06/meta-research-update/ http://blog.givewell.org/2013/06/06/meta-research-update/ edit: I linked to the wrong review before (not the one under discussion), so I edited that out. As gwern mentions in another comment, the link is broken in the BBC article. nairteashop found a different news release which seems to be the right link: http://www.cochrane.org/features/tamiflu-relenza-how-effective-are-they http://www.cochrane.org/features/tamiflu-relenza-how-effecti...

sithu 13y ago
I agree with most of what you've said, except that I think the recent enthusiasm for doing systematic reviews + meta-analysis is way overblown. What really needs funding is novel high-risk/high-reward research that isn't necessarily supported by precedent data.

microjesus 13y ago

This is like Vitamin C. No one believes me that it's been debunked. My god, the things that marketing can sell which are of no use.

smtddr 13y ago
I dunno about that. Those Emergen-C 1000mg Vitamin C powder packs work wonders for me. If it's been debunked then I got some kinda crazy placebo effect going on.
- js2 13y ago
  8.1. Cold and Flu According to meta-analyses on the topic assessing doses of 200mg vitamin C or more, vitamin C has failed to reduce the frequency of colds in the normal population but was successful in reducing the duration of colds (on average 8-14%);[149][145] when looking at studies investigating extreme physical stress (marathoners and skiiers), the risk of getting a cold was halved (which has been noted in past meta-analyses[144]) http://examine.com/supplements/Vitamin+C/#summary8-0 http://examine.com/supplements/Vitamin+C/#summary8-0
  - smtddr 13y ago
    That's actually in line with how I use it. Definitely not a marathoner/skiier but I work out about an hour a day and I never expect Vitamin-C to prevent colds. I only take it after 2 to 3 day of sensing an incoming cold.
    - vixen99 13y ago
      I remember a recent study found that vitamin C had no effect on the period or severity of a cold but zinc did. Seems to be confirmed by this :- https://www.ncbi.nlm.nih.gov/pubmed/15496046 https://www.ncbi.nlm.nih.gov/pubmed/15496046
mmariani 13y ago
Did you even read the article? Marketing had nothing to do with the "success" of this drug. Good and old FUD did. The drug was sold directly from Roche to governments. Typical HN bias, it's all marketing's fault. Next time just follow the money.

tptacek 13y ago

I thought it was pretty well-known that Tamiflu wasn't particularly effective, and that the UK NHS had already been criticized for stockpiling it.

crazytony 13y ago
this is the lingering problem: it's terribly ineffective if you go to the doctor with flu symptoms. Seriously. Tamiflu blocks the channels used to multiply the influenza virus. By the time you recognise you have the flu Tamiflu looks to be completely and utterly ineffective. I haven't seen a societal study to say it's better or worse as a group of individuals. I would be really interested in that.

deleted 13y ago

[deleted]

willvarfar 13y ago

In Sweden, almost everyone was vaccinated with Pandemrix http://en.wikipedia.org/wiki/Pandemrix http://en.wikipedia.org/wiki/Pandemrix I think this is not the same exact drug as Tamiflu, but the parallels - mass vaccination etc - are worth drawing. The scary thing about Pandemrix is that some people - mostly children and young adults - immediately got narcolepsy http://en.wikipedia.org/wiki/Narcolepsy http://en.wikipedia.org/wiki/Narcolepsy Now the various investigations have all said they can find no link between narcolepsy and Pandemrix, and yet they don't really explain the suddenness of it all. Seems a hell of a coincidence. Narcolepsy is not some silly little "sleep disorder". This was really brought home to me - literally - by knowing someone who's child got it hours after their Pandemrix jab =( The micro-problem here is the Swedish state trying to avoid paying for care (its untreatable, as I understand it) and all that wrangling about taking responsibility. I think most parents of suffers are really out to share around the burden of responsibility, rather than caring so much about the costs of care. The macro-problem is convincing people that the next time we are told to go get a jab, we should :( Here's Penn & Teller talking about Vaccines: https://www.youtube.com/watch?v=RfdZTZQvuCo https://www.youtube.com/watch?v=RfdZTZQvuCo Science isn't going to win over my wife as easily as all that. And I am very divided myself, however rational I try and be.

beedogs 13y ago
Tamiflu isn't a vaccine; it's an antiviral. You take it when you already have flu symptoms.
- willvarfar 13y ago
  The parallel was not the drug, it was the government program and the money.

bananas 13y ago

I got given some of this in the UK when I had the sniffles during the panic. I didn't actually go to the doctors for that problem. Ultimately I didn't take them and I suspect that most people didn't or they were disposed off after the discard date. Some people walked off with a fucking huge pile of cash after that one...

robmcm 13y ago

It's a bit like saying we wasted millions of preparing for heavy snow in the UK this year as we got none. If H1N1 or derivatives caused a serious pandemic I would much rather have some Tamiflu than not, even if it's effectiveness varied for patient to patient. It's easy to say money was wasted with hindsight.

kitd 13y ago
I don't think your analysis is correct. They're not saying that the money is wasted because we haven't had a flu outbreak. They are saying that, if there was one, Tamiflu would be as useful as paracetamol. It would be like (in your analogy) someone claiming that the snow clearing equipment bought was known to be faulty or not work in cold conditions. In that case, saying the money was wasted would be justifiable. I don't have an answer, other than the observation that there are too many cases these days where public health and commerce don't work well together.
- robmcm 13y ago
  > I would much rather have some Tamiflu than not, even if it's effectiveness varied for patient to patient. At the time Tamiflu was believed to work well, and must have had studies that backed this up (otherwise it wouldn't have got past NICE). If it is in fact no better than paracetamol then with hindsight you could argue it was a mistake to stockpile, however I was reassured that my government had prepared, which in itself could have avoided some additional panic and bad press.

bencollier49 13y ago

Is this another casualty of the "selective publication" of results performed by pharma companies?

tokenadult 13y ago

The follow-up article on this report[1] from Science-Based Medicine provides more details and good perspective on the difficulty in general of studying the safety and effectiveness of new treatments of any kind for any condition. [1] http://www.sciencebasedmedicine.org/new-evidence-same-conclusion-tamiflu-only-modestly-useful-for-influenza/ http://www.sciencebasedmedicine.org/new-evidence-same-conclu...

gwern 13y ago

Fulltext: http://www.bmj.com/content/348/bmj.g2545 http://www.bmj.com/content/348/bmj.g2545