[Two decades later, the polypill revisited].

TWO DECADES LATER, THE POLYPILL REVISITED Twenty years later, the promises of the designers of the Polypill are far from being fulfilled. Its effectiveness is still open to debate, while its long-term adverse effects in healthy subjects, particularly due to aspirin, continue to cause concern. Its composition, which varies from one Polypill to another, does not always appear to be as relevant as it would be desirable.

[The war against generics and biosimilars in France: game over?].

"The war against generics and biosimilars in france: game over? French people seem get accustomed to generics use after a period of approximately two decades punctuated with reluctance, controversies, behavioral barriers, incentives, conventions and regulations. Fortunately the recent so-called Levothyrox crisis and the more confidential one about Valsartan have not had the deleterious impact that was feared. A more peaceful atmosphere if not resignation can now be noticed.

[For an optimal use of fixed drug combinations].

Due to the increasing use of fixed-dose combination therapy (FC) for treating several pathological conditions, the authors discuss their advantages (simplification of drug intakes and thus possible better compliance, rationale of pharmacological associations and drug dosages) and their disadvantages (limited dosage flexibility, possible misunderstanding of the co-administered drugs due to non-utilization of International nonproprietary name…) versus advantages and disadvantages of free drug combinations. Several recommendations are proposed. If FC is not in fact a problem in young adults with stable diseases, it should be cautiously prescribed for all the other patients, especially in elderly suffering from several diseases.

The public health benefit of medicines: how it has been assessed in France? The principles and results of five years' experience.

Health technology assessment seeks to inform health policy- and decision-makers by promoting use of current best evidence and by addressing country specific factors, such as local context and values. In France, public health benefit (PHB) is one of the criteria used to inform decisions on the reimbursement of medicines. This article describes the methodological framework and the results after five years of assessment of PHB, by the French National Authority for Health.

Relative effectiveness assessment of listed drugs (REAL): a new method for an early comparison of the effectiveness of approved health technologies.

Objectives: Post-listing assessment of pharmaceuticals depends on national habits. In England, the assessment is based on estimates of cost per quality-adjusted life-year. These are made some considerable time after listing (negative list).

[Access to medicines in France].

In France the total cost of medicinal products reimbursed by health insurers in 2007 was over 25 thousand million euros, and access to new drugs is neither restricted nor rationed, despite the unfavorable economic situation. In 2007 and 2008 the Transparency Commission (TC) of the French National Authority for Health (Haute Autorité de Santé) approved the reimbursement of 97% of new drugs and new indications for existing products, within 90 days on average. The 3% of medicinal products that were not approved did not represent therapeutic advances and could be considered to be of dubious utility.

Determinants of coprescription of anxiolytics with antidepressants in general practice.

Objectives: Anxiolytics are the most frequently prescribed psychotropic drugs in France. General practitioners (GPs) tend to prescribe anxiolytics and other benzodiazepines to patients with major depressive disorders (MDD). However, the extent to and reasons for which they prescribe these medications together are not well documented.

[The benefit provided by new medicinal products in 2005-2006--the viewpoint of the French National Authority for Health].

The French National Authority for Health (HAS) assesses the actual benefit provided by medicinal products within a defined legal framework. It provides an independent scientific opinion. It aims to ensure equity, taking into account a variety of points of view as a result of close collaboration with health professionals.

[Targeted anti-cytokine therapies for osteoarthritis].

Proinflammatory cytokines such as interleukin-1 beta and, to a lesser extent, tumor necrosis factor (TNF) alpha, play a key role in the destruction of the cartilage matrix in osteoarthritis. Intraarticular injection of specific IL-I inhibitors or antagonists has been shown to slow disease progression in animal models of osteoarthritis. A first randomized placebo-controlled trial of a IL-1 beta antagonist (a single intraarticular injection of 50 or 150 mg) had no analgesic effect during 3 months of follow-up.