Why Don’t Drug Labels Make the Actual Harms and Benefits Clear?

By Jacob Molyneux, blog editor/senior editor

How can we know if a drug really works? Gary Schwitzer, publisher of HealthNewsReview.org (an incisive Website that grades the quality of health news reporting) addresses this question on his blog this week by drawing attention to a recent perspective piece published in the New England Journal of Medicine (NEJM). It’s called “Lost in Transmission — FDA Drug Information That Never Reaches Clinicians” and it states the problem clearly:

The 2009 federal stimulus package included $1.1 billion to support comparative-effectiveness research about medical treatments. No money has been allocated — and relatively little would be needed — to disseminate existing but practically inaccessible information about the benefits and harms of prescription drugs. Much critical information that the Food and Drug Administration (FDA) has at the time of approval may fail to make its way into the drug label and relevant journal articles.

The most direct way that the FDA communicates the prescribing information that clinicians need is through the drug label. Labels, the package inserts that come with medications, are reprinted in the Physicians’ Desk Reference and excerpted in electronic references. To ensure that labels do not exaggerate benefits or play down harms, Congress might have required that the FDA or another disinterested party write them. But it did not. Drug labels are written by drug companies, then negotiated and approved by the FDA.

One example given in the NEJM article is the sleeping pill Lunesta:

Clinicians who are interested in (Lunesta’s) efficacy cannot find efficacy information in […]

Readers Comment on Vicodin, Percocet Ban

pillsinspace

In his July 6 post on the proposed Vicodin, Percocet ban, AJN editor Jacob Molyneux wrote, “A number of clinicians and patients have expressed alarm at the potential loss of Vicodin and Percocet, both of which are mainstays of pain management in the U.S.” He cited pain expert Carol Curtiss’s concern that such a ban could have “even more drastic implications than most people yet understand,” then asked readers, “Should we worry?”

Some commenters think so:  nester writes

If suddenly the combos become unavailable and pain relief is that much harder to come by, every Tom, Dick, and Harry with a sprain is going to flock to the ER for the good stuff… not once, but daily until the pain is gone or they are refused treatment.  If you can’t go to just any doc to get narcotic pain relievers, the pain relief specialists will have lines out the door also.

And Abigail Nobel says, “Educate before banning these affordable, essential components of pain control. Why should everyone suffer for the carelessness of a few?”

But Judy Newberger says that although she initially agreed with the ban, an interview with an elderly patient who was given Percocet and was already taking acetaminophen changed her mind.

Labels were not read, discharge papers were not thoroughly reviewed. Did no one review what meds he was on before they sent him home? I now am FOR removing Rx and OTC combination pain and other combination meds with acetaminophen.

Thanks to all for […]

2016-11-21T13:25:09-05:00July 17th, 2009|nursing perspective, pain management|0 Comments
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