Deaths from pharmaceuticals are one of society’s best-kept secrets. We have no idea of the actual numbers—but what we have discovered is worrying enough
A medical correspondent to a national newspaper once explained to us, rather patronizingly, that prescription drugs are “a sharp sword that sometimes cuts people’s heads off.”
Quite a few heads roll, although nobody has a clue just how many. The World Health Organization’s VigiBase system, which tries to capture the number of adverse drug reactions (ADRs) around the world, recorded more than 23 million cases between 2010 and 2019 (see charts below).
Looking at 3.25 million of them, researchers at INSERM in France found that 43,685 were fatal reactions. The implication is that around 1.34 percent of all ADRs result in death.1
In the US alone, it is estimated that around 180,000 people die every year from an ADR, and a further million suffer long-term harm or injury. Many will need hospital care, and it’s estimated that 5 percent of all US emergency hospital admissions are to treat a serious drug reaction.2 In the UK, the estimate is 16.5 percent of admissions, even when considering only stays of greater than 24 hours.3
But nobody really knows how many ADRs there are in the first place; it requires a healthcare worker to identify a case and record it. The UK Yellow Card system provides a way for them to do so but captures less than 5 percent of all cases, researchers estimate, which is why patients are now encouraged to report these events themselves.4
Despite this level of underreporting, the fatal effects of pharmaceuticals are well established. ADRs have been identified as the fourth major cause of death in the US—after heart disease, cancer and stroke5—and between the fourth and sixth major cause worldwide.6
That’s a lot of heads.
Analyzing drug-related deaths between 2010 and 2019, as reported to the World Health Organization’s VigiBase system.1
Total deaths analyzed: 43,685
| Age range | Deaths |
| 18–44 years | 5,280 (12.1%) |
| 45–64 years | 13,601 (31.1%) |
| 65–74 years | 10,262 (23.5%) |
| ≥75 years | 14,542 (33.3%) |
Analysis of the drugs responsible for 43,685 deaths reported to the World Health Organization’s VigiBase system between 2010 and 2019.1
| Name | Brand name | Type | Total deaths |
| Denosumab | Xgeva/Prolia | Bone cancer | 2,611 (5.4%) |
| Lenalidomide | Revlimid | Blood cancer (myeloma) | 2,083 (4.8%) |
| Thalidomide | Contergan/Thalomid | Cancer | 1,869 (4.3%) |
| Clozapine | Clozaril/Versacloz | Antipsychotic | 1,761 (4.0%) |
| Bosentan | Tracleer/Safebo | Antihypertensive | 1,373 (3.1%) |
| Bevacizumab | Avastin | Cancer | 1,301 (3.0%) |
| Macicentan | Opsumit | Antihypertensive | 1,298 (3.0%) |
| Imatinib | Gleevec | Cancer | 1,060 (2.4%) |
| Alprazolam | Xanax/Intensol | Tranquilizer | 752 (1.7%) |
| Oxycodone | Oxycontin | Opioid pain reliever | 606 (1.4%) |
| Drug type | Deaths per million |
| Antidepressants | 21.1 |
| Benzodiazepine | 18.8 |
| New psychoactive substance | 9.0 |
| Paracetamol | 7.8 |
| Codeine | 7.0 |
| Tramadol | 6.8 |
| Antipsychotic | 5.7 |
| Zopiclone (insomnia) | 4.7 |
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