Unnecessary and Expensive Therapy
For several years, it has been known that the pharmaceutical company Roche had held back a large amount of study data on oseltamivir (Tamiflu). Further, after publication of these data, significant corrections were required for both the effectiveness as well as the number needed to treat (NNT). With its currently acknowledged shortening of disease duration by 0.5 days, Tamiflu has achieved the efficacy of Echinacea herbal products—which, according to studies, also shorten disease duration of patients with mild to moderate influenza by 0.5 days. Likewise, antibiotics reduce moderate bronchitis duration by 0.5 days and are therefore not indicated. Unfortunately, the Robert Koch Institute (RKI) and the Institute for Quality and Efficiency in Health Care (IQWiG) have yet to issue new, sensible statements, which has led to the fatal, expensive, and nonsensical practice of using neuraminidase inhibitors. Especially in times when politicians as well as health insurance companies propagate various prevention strategies, while patients with osteoporosis receive prophylactic therapy paid by a health insurance only after the occurrence of a pathological fracture, an unnecessary and expensive therapy should not be recommended to the detriment of the statutory health insurance funds. It is also peculiar that this article (1) appeared just at the beginning of the flu season. I trust that neither the authors of the review nor the various colleagues that they acknowledge had conflicts of interest.
Praxis für Allgemeinmedizin, Halstenbek, Germany
|1.||Lehnert R, Pletz M, Reuss A, Schaberg T: Antiviral medications in seasonal and pandemic influenza—a systematic review. Dtsch Arztebl Int 2016; 113: 799–807 VOLLTEXT|