[Analysis of regulatory status changes of drugs in France: 2010-2019]

OBJECTIVES

The existence of borderline products between the status of a medicinal product and other less regulated products allows some products to have different statuses or even to change from one status to another. In order to quantify these changes, a review of medicines that have changed from drug status to other statuses (medical device, cosmetic product or food supplement) in France between 2010 and 2019 was performed.

METHOD

The lists of medicinal products with archived or revoked marketing authorization (MA) from the French National Authority's Register of Medicinal Products were analyzed in order to identify the medicinal products withdrawn from the market between January 1, 2010 and September 30, 2019 that could be considered as products with a "potential for status change". Then, we searched on the official websites of the MA holders and other firms, for a possible return to the market with a different status, marketed by the same firm (self-change of status) or a different firm (hetero-change of status).

RESULTS

Out of a list of 206 drugs identified as "with potential for status change", we detected a total of 101 status changes, including 36 auto-changes and 65 hetero-changes. These changes mainly concern vitamin or herbal drugs later marketed as food supplements (30 cases of auto-changes and 60 cases of hetero-changes). There are also 6 cases of switching to cosmetic product and 5 cases of switching to medical device.

CONCLUSION

The existence of no clear distinction between the different statuses of health products facilitates their status changes. The increasing shift from "medicines" to less regulated products, the trivialization of their use by the public and their increasing consumption make them a fundamental issue of social pharmacology, requiring to raise the awareness of consumers and health professionals.

[A French survey on the resort of oral alternative complementary medicines used in children with cancer]

INTRODUCTION

The use of oral complementary and alternative medicine (CAM) is widespread among cancer patients, but considerably less known in pediatric cancer patients. Our survey was conducted in a pediatric onco-hematology unit to study the frequency and the circumstances of CAM use.

METHODS

This study included 50 children treated for malignant diseases. A questionnaire was used to collect support general data on the child as well as information on the CAM use. One of the child's parents was interviewed.

RESULTS

Most of parents (48%) used one or more CAM for their child in the context of cancer. The most used type of CAM was homeopathy, dietary supplements and aromatherapy. The most frequent goal for CAM use was to limit the side effects of conventional treatment (75% of parents). For 87.5% of users, the CAM was effective. Physicians were not aware of this use for 33.3% of users, in spite of the fact that the family physician was the main source of information for this use. Most of parents (48%) needed more information about the CAM and they bought CAM in a pharmacy.

CONCLUSIONS

The use of oral CAM in this survey was common. For most parents, this use was effective and appreciated because they generated fewer side effects than conventional treatments. However, doctors were not systematically informed of this use. This is problematic because some CAM such as herbal supplements could potentially cause interactions with cancer treatments. More information about CAM is necessary in pediatric onco-hematology.