New drugs seem to be getting more toxic. Since 1997, more drugs have been withdrawn because of toxicity than in any other era in the history of modern medicine. Some of these drugs were prescribed millions of times before the authorities acted.
Dr Alastair Wood, from the Vanderbilt University Medical Center in America, reckons that 19.8 million patients - which equates to 10 per cent of the US population - have been exposed to just five of 10 drugs withdrawn since 1997.
'None of the drugs was indicated for a life-threatening condition nor, in many cases, were they the only drugs available for that indication,' Wood added (JAMA, 1999; 281: 1753-4).
Britain and the US are not two isolated examples. Dr Thiery Buclin, a Swiss health official, has said that, in 1998 alone, of the 30 medicines approved that year, five had to be removed later.
Buclin puts the blame squarely on the prelicensing process, which he believes can be too hasty, and then on the post-licensing period, when drugs are aggressively marketed. 'We have proof of too much hastiness and sometimes a lack of prudence. The pharmaceutical industry plays the first role in this dangerous game. With aggressive marketing, it uses heavy infantry to convince health personnel' (from an interview in Dimanche newspaper, 2 April 2000).