Phrases that include words such as 'tips' and 'icebergs' come to mind when the scale of adverse reactions to pharmaceutical drugs has tried to be established.
One French study reckoned that just 1 in 20,000 reactions is ever reported, while the Yellow Card system in the UK has been a valiant failure. In virtually every reporting system, on both sides of the Atlantic, it's down to the doctor to do the paperwork. He either doesn't have the time, or he doesn't believe the drug has caused the effect, or perhaps he's being 'funded' by the pharmaceutical company to recruit unwitting patients in an invaluable 'trial' of the drug.
So the UK government came up with the astonishing idea that patients should be allowed to report their own reactions to a drug. They tested it over a 15-month period in one area of the UK to see if it is an idea worth introducing throughout the whole of the UK.
But in all that time just 39 reports of adverse reactions were received. So are drugs safer than we feared, or could it be that the public couldn't care less about better drug policing? Whatever the reason, it hardly seems worth the trouble and expense of democratizing medicine.
But hold! Could there be a third reason? Yes, of course, those who organized the trial forgot to tell anyone about it! Doctors in the area heard about it only for the first time last week when they read of its failure in the British Medical Journal. And a quick straw poll among pharmacists in the area found that they had never heard about it, probably because they don't read the journal.
This vexing dilemma has only one solution, health experts agree. The real problem is that patients in the trial area had to report reactions to NHS Direct, the 'public face' of the National Heath Service. Response would be far better if patients could report directly to the Medicines and Healthcare Products Regulatory Agency. The agency in turn passes on its findings to the Committee on the Safety of Medicine, which has been criticized for being one of the most secretive groups in the UK, funded and run by the pharmaceutical industry.
That way we can get back to those tips and icebergs, and everyone can agree that at the very least they tried.
* To find out what's really going on in the world of pharmaceuticals, one book you really should read is Secrets of the Drugs Industry. To order your copy, click on this link: http://www.wddty.co.uk/shop/details.asp?product=341