Most drugs in the top-12 of sales in Ukraine have no proven efficacy.
Ukraine - one of the few countries with very favorable conditions for the promotion of medicines. In particular, the following three items should be noted:
Most medicines are sold without a prescription.
Permission to advertise all registered OTC.
No institution provides control of the information given on the drug’s packaging in accordance with the principles of evidence-based medicine.
In Ukrainian pharmaceutical market shows steady growth for the past 9 months. Thus, compared to the same period in the last year it demonstrates an increase in drugs sales by 9.3% and in monetary terms by 18.3%
Of course, pharmaceutical companies are interested in the best possible sales of their products. For this purpose, in Ukraine, they have all needed possibilities, including an impact on the doctor's opinion and influence on the patient’s choice (by advertisements). If physicians can make the decision based on their knowledge and skills, objectively evaluate data for a given active substance, patients do not have such opportunity. In addition, the possibility of doctors for the clinical trials data analysis is also limited due to the language barrier (most guidelines and studies are published in English) and possible conflict of interest, which is not controlled by the public or government.
In this brief review, we have analyzed the evidence base for each drug, which is in the top 12 of sales in Ukrainian retail networks.
Top-12 drug list was obtained from the newspaper "Pharmacy" (for the first 9 months of the 2017 year)
The approved active ingredient (at least one brand), or combinations by the US Food and Drug Administration (FDA). Data searching was performed on the institution’s official website
The presence of the active ingredient in the clinical guidelines of the National Institute for Health and Clinical Excellence (NICE). Search was conducted on the official website of this organization
Published Cochrane Systematic Reviews on the active ingredient
Results are presented in
Brand name | Main active ingredient(s) | Presence of the active ingredient in the NICE guidelines | Approval by FDA | Presence in the Cochrane Reviews | Confirmed effectiveness in the Cochrane Reviews |
---|---|---|---|---|---|
Aсtovegin | Filtered extract obtained from calf blood | - | - | - | - |
Nurofen | Ibuprofen | + | + | + | + |
Nimesil | Nimesulide | - | - | + - (indirect review) | - |
Sodium Chloride | Sodium chloride | + | + | + | + |
Nospanum | Drotaverine | - | - | + - (labour) | - |
Essentiale | Polyenylphosphatidylcholine | - | - | - | - |
Reosorbilact | Sorbitol | - | - | - | - |
Ringer's solution (sodium chloride, potassium chloride, etc.). | + | + | + | + | |
Citramon | Acetylsalicylic acid, paracetamol, caffeine | + | + | + | + |
Spasmalgon | Metamizole sodium | - (ban) | - (ban) | - | - |
Pitofenon | - | - | - | - | |
Fenpiverinium bromide | - | - | - | - | |
Sinupret | Primula veris, Gentiana lutea, Sambucus nigra, etc. | - | - | - | - |
Tyvortin | Arginine hydrochloride | - | - | - | - |
Cardiomagnyl | ASA | + | + | + | + |
Magnesium hydroxide | - | - | - | - |
Briefly about each medication with questionable evidence base:
The author declares that no competing interests exist.
The author declares that no competing interests exist.