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Letter to the Editor
Editor, – The editorial by Sidney Wolfe (Aust Prescr 2012;35:138-9) suggested that patients should not take any pharmaceutical drugs that have been released until they have been taken by other patients for seven years. By that time, half of the black box warnings or market withdrawals that would ultimately occur for a drug over its lifespan would have already happened.
The logical corollary of this, if it was adopted by all patients, is that the seven-year rule would immediately become an infinite year rule as no patients would be taking any new drugs. Clearly, widespread adoption of this recommendation would have profound effects on achieving any improvement in disease states, let alone the capacity of pharmaceutical companies to continue to exist. The editorial reports that even 25 years is not long enough to exclude the possibility of a new black box warning or market withdrawal.
Perhaps it would be better to outline to patients that changes to medication recommendations can occur and half of these occur within the first seven years and leave it to a harm–benefit discussion between the patient and their prescriber about whether the new medication should be trialled or not.
I do not think that blanket ban approaches are particularly helpful or necessarily balanced.
Pain medicine physician and specialist