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August 19, 1974

The ADR Numbers Game

Author Affiliations

Director, AMA Department of Drugs

JAMA. 1974;229(8):1097-1098. doi:10.1001/jama.1974.03230460047024

Since the first galenical preparations were administered to sick individuals, physicians have known that the drugs themselves have the potential of producing adverse and, occasionally, fatal effects. Indeed, iatrogenic disease resulting from drugs is a recognized and accepted hazard of medical practice. The aim of rational drug therapy, therefore, is to choose the course of treatment that will achieve the desired therapeutic results with the least amount of drug-associated toxicity. Although these facts are obvious to all physicians, the lay public has recently been subjected to a macabre "numbers game" about fatal adverse drug reactions (ADRs) that is as alarming as it is sensational.

In 1972, Talley and Laventurier1 presented a paper in which they estimated that 30,000 deaths caused by ADRs occurred the previous year in the United States. This figure lay fallow until late 1973, when it was picked up by Senator Kennedy during the drug hearings