Source: San Jose Mercury News (CA)
Pubdate: Wed, 15 Apr 1998
Author: Rick Weiss - Washington Post


Study: Medicines kill 106,000 patients a year

More than 2 million Americans become seriously ill every year because of
toxic reactions to correctly prescribed medicines taken properly, and
106,000 die from those reactions, a new study concludes. That surprisingly
high number makes drug side effects at least the sixth, and perhaps even
the fourth, most common cause of death in this country.

The analysis, the largest and most complete of its kind, suggests that 1 in
15 hospital patients in the United States can expect to suffer a serious
reaction to prescription or over-the-counter medicine, and about 5 percent
of them will die from it.

If the findings are accurate, the number of people dying each year from
drug side effects may be exceeded only by the numbers of people dying from
heart disease, cancer and stroke, and may be greater than the number dying
from lung disease, pneumonia or diabetes.

But pharmaceutical manufacturers, drug regulators and the researchers
themselves warned against overreacting to the numbers, noting that the
study made no effort to measure the benefits of the same medicines -- an
equally important part of the cost-benefit calculation that determines the
overall usefulness of a drug.

``We're not saying, `Stop taking drugs,' '' said Bruce Pomeranz, the
University of Toronto neurophysiologist who initiated the study. For
example, he said, blood thinners may cause fatal bleeding in some but also
save countless lives by preventing heart attacks.

Experts said the study, which appears in today's issue of the Journal of
the American Medical Association, is stronger than previous ones because it
looks only at cases in which drugs were taken correctly. Previous hints of
similarly high side-effect rates had been attributed in large part to
people getting the wrong medicines or taking them in the wrong doses.

Only one-quarter of the reactions were due to patients being allergic to
the drug in question. In theory, those reactions could be avoided by more
carefully asking people about known allergies. The rest of the side effects
were classified as essentially inevitable, bound to affect a certain
percentage of the population for unknown reasons.

Pomeranz called for research to determine which drugs are most problematic
and which patients are most at risk -- information the current analysis did
not try to gather. He said hospitals should set up improved systems for
tracking adverse reactions as they occur, and for reporting them to federal
regulators so medicine labels can be updated and physicians and consumers
can be better informed about the risks and benefits of their medicines.

Michael Friedman, acting commissioner of the Food and Drug Administration,
said the agency has implemented new systems for preventing, identifying and
keeping track of adverse drug reactions. A nationwide electronic network
now allows doctors to report adverse reactions easily over computer lines.
A growing number of pharmacies are using an FDA-supported system that
automatically prints out side-effect warnings and other information for
consumers when they pick up their medications.