BACKGROUND: Tamiflu® (oseltamivir) is used to treat influenza virus, the virus that causes the "flu." Tamiflu® is recommended by the CDC in almost all patients who present within 48 hours of symptom onset. Tamiflu® is also listed as an "essential drug" by the World Health Organization.

Many of the trials involving Tamiflu® were never published. Four years ago, the Cochrane Collaboration requested all the study data pertaining to Tamiflu® from Roche®, the drug's manufacturer. Roche® balked, and over the next four years, a battle ensued that involved the British Medical Journal, Roche®, and the European Medicines Agency (the European version of the FDA). Finally, in 2013, Roche® agreed to release the data to the Cochrane Collaboration. The Cochrane Collaboration performed a meta-analysis on the data, and the results are presented below.


StraightHealthcare analysis: This long-awaited meta-analysis calls into question the benefits of Tamiflu. Tamiflu appears to decrease the symptoms of flu in adults by about 17 hours at the cost of increased nausea and vomiting. Tamiflu had no obvious benefit in children. When it comes to clinically important outcomes like pneumonia and hospitalization, Tamiflu showed no proven benefit in any group.

The CDC released a statement after the BMJ meta-analysis was published in which they stood by their previous recommendation that almost all patients receive Tamiflu if treated within 48 hours of symptom onset (see CDC statement). In their discussion, they cite evidence from observational studies to support their position on Tamiflu.

Based on the available evidence, Tamiflu has no proven significant effect on clinically important outcomes. Widespread outpatient use is not supported. Whether Tamiflu improves outcomes in sicker, hospitalized patients is unclear.