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SIDE-EFFECTS 'COSTING NHS 1BN A YEAR'

The Daily Telegraph
February 13, 1992
by Peter Pallot,
Health Services Staff

MORE than 10,000 hospital beds are constantly occupied by people suffering from the side-effects of prescribed drugs, Social Audit, a consumer research body, said in a book published yesterday. The claim was based on four studies between 1981 and 1988 suggesting that adverse reactions to drugs were to blame for between three and five per cent of admissions, said Mr Charles Medawar, the author. The cost to the National Health Service of the side-effects of cardiovascular, arthritis and ulcer medicines and antibiotics was up to 1 billion a year, said Mr Medawar, who was scientific co-ordinator of legal actions by patients against Eli Lilly over the arthritis drug Opren. He said patients were kept in ignorance of risks associated with drugs, doctors were bamboozled by drug salesmen and the Committee on Safety of Medicines worked in secret and was packed with people who had financial links to drug companies.

'All but four of the 23 committee members had industry connections and when they reviewed a product of a company such as Glaxo a third of them should declare an interest', said Mr Medawar.

'The secrecy we are complaining of tends to protect the product more than the conscientious prescriber or his or her patients,' he said. Official complacency was demonstrated in 1980 when the committee said there were only 28 dependence cases linked to anxiety-relieving benzodiazepines. 'Anyone taking the drugs would have known that was balderdash,' said Mr Medawar.

About 12,000 patients are suing the makers of drugs such as Librium, Valium and Ativan, which were introduced 30 years ago. The book condemns the gullibility of drug licensing agencies and doctors for thinking there were non-addictive tranquillisers. 'First it was alcohol and opium; then morphine, cocaine and heroin; then chloral, bromides and barbiturates - until it was the turn of the benzodiazepines.' On secrecy, the report says: 'In the United States and other countries - perhaps before long in the European Community - the authorities outline their reasons for granting a product licence.

In the UK the authorities do not explain themselves and prefer not to.' Four in five GPs had never reported an adverse drug reaction. Yet research in 1988 by Prof Michael Rawlins, who was named on Tuesday as the new head of the Committee on Safety of Medicines, concluded: 'There is clear evidence that only a small proportion (rarely exceeding 10-15 per cent) of even severe reactions are reported to the committee.' Mr Medawar said: 'Optimistically, assuming a reporting rate of one serious reaction in every 10, the true incidence of adverse reactions might be 50,000 serious reactions and 2,500-3,000 fatalities a year.' The report was backed by Dr Andrew Herxheimer, consultant pharmacologist at Charing Cross Hospital in London, who said the figures for hospital admissions of drug-damaged patients took no account of those who remained at home under the care of their GP.

The Association of the British Pharmaceutical Industry said that under-reporting of adverse reactions was a recognised problem but those that were reported tended to be the serious ones. It was not logical to multiply the number of side-effects by 10 or to deduce a figure of up to 3,000 deaths. Power and Dependence, by Charles Medawar, director of Social Audit. 10.


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