The Ministry of Health intends to withdraw ineffective drugs from the pharmaceutical market

This year the Russian Ministry of Health will launch a campaign to withdraw ineffective drugs from the pharmaceutical market, said the head of the ministry, Veronika Skvortsova. The list may include many anti-aging and hair-loss products and immune boosters whose efficacy has not been proven and which, in the opinion of many doctors, do not work. Experts also propose removing herbal tinctures from pharmacies as belonging to 19th-century medicine.

According to the Minister of Health, the ministry has already drafted amendments to the law “On the Circulation of Medicines” concerning drug registration. The aim is to keep on the market “only demonstrably effective and high-quality drugs.” The ministry also plans to review the entire range of drugs on the Russian market this year and gradually withdraw those that reached pharmacy shelves without solid evidence of efficacy from limited clinical trials.

Once the amendments are adopted, a “negative drug list” will be compiled of products whose efficacy has not been proven, Professor Vasily Vlasov of the Moscow Medical Academy, president of the Society of Evidence-Based Medicine Specialists, told NI. In his view, such drugs should at least not be purchased by the state with taxpayer money — and at most should leave pharmacy shelves: “We already have very little healthcare funding, and the money goes to manufacturers and distributors selling placebos.”

There is no official concept of “ineffective drug” — the phrase itself sounds like an oxymoron. Independent experts propose classifying as ineffective those drugs whose therapeutic effect has not been proven in reliable clinical trials conducted in full compliance with evidence-based medicine. Professor Vlasov argues that dietary supplements should first be separated from drugs: “Supplements are heavily advertised and sell well with us, but they are not drugs — they do not treat anything. Yet people use them as drugs.”

Pharmacists group drugs by mechanism of action and by the diseases they are intended to treat. Vlasov says there are ineffective drugs in every group — in some, just a few; in others, the vast majority: “Some groups contain drugs that have either no efficacy at all or at most a tiny effect.” Most unproven drugs are aimed at incurable diseases. “For these conditions all sorts of things are sold,” Vlasov adds. These include hair loss and senile dementia (Alzheimer’s). Even the newest and most expensive products have a “negligible effect,” according to Vlasov, but “people still spend significant money on them because there are no alternatives and they need to at least slow the disease.” Some products “are made by medieval technology from animal-derived material and have no proven efficacy.”

Experts also classify as ineffective all drugs claiming to slow aging (no miraculous elixir of youth has been invented) and all immunomodulators. “In reality it is practically impossible to improve immunity — you can only suppress it, for example through exhausting physical exertion,” says Vlasov.

Last year deputies of the Kursk Regional Duma tried to legislate a ban on the free sale of medical tinctures of hawthorn, pepper and ginseng — arguing they are often taken not for health but for their high ethanol content. Modern medicine has no need for tinctures at all, MD Kirill Danishevsky told NI: “These are an outdated 19th-century inheritance along with leech therapy. But tinctures are still used here because people love to drink alcohol under the guise of treatment.” “Unlike normal drugs, herbs and tinctures are hard to standardize,” Professor Vlasov adds. “We do not really know what is in there, especially in combination blends. Therefore serious medicine today does not really use these. Though we should not generalize — some herbs really do have pharmaceutical effects, for example valerian root has a real calming effect.”

Modern medicine also classifies homeopathy as a pseudo-treatment — an alternative-medicine approach based on the use of highly diluted products by healthy people for prevention. WHO warns against homeopathic treatment of infectious and any other serious diseases because “the use of homeopathy has no evidence base and, when used as an alternative to primary treatment, poses a real threat to life and health.”

Source: Novye Izvestia