Withdrawal of useful drugs from the market

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Editor, – The editorial 'Withdrawal of useful drugs from the market' (Aust Prescr 2003;26:50-1) makes a cogent observation about discontinuation of old drugs. The newer antidepressants, antipsychotics, antihypertensives and drugs for diabetes may have some advantages, but they are certainly not worth the high cost.

Most of the useful old drugs are included in the essential drugs lists of the World Health Organization or of developing countries. If it was compulsory for the drug manufacturers to inform people about the discontinuation of essential drugs, it would be easier for governments to make the drugs available as generics or as generic brands.

Wishvas Rane

Editor, – I found Dr Lyndon's editorial (Aust Prescr 2003;26:50-1) on the withdrawal of drugs very pertinent.

Dr Lyndon correctly states there are many reasons for pharmaceutical companies to discontinue supply of a drug. Although their reasons are generally understandable, this does not help those patients for whom the remaining commercially available alternatives are less effective. I would like to advise prescribers that there is a route available in Australia, perhaps not widely known, to obtain most discontinued medication.

Compounding pharmacies prepare and supply medication (known as extemporaneous preparations) for individual patients. As long as the pharmacists can source raw material and do not infringe any patents, they are able to produce virtually any medication. They can produce medication that is no longer available here or that is available overseas but has not been released in Australia (often due to a perceived lack of sufficient demand).

I believe Dr Lyndon is quite right in his concerns that there is no co-ordinated process involving all interested parties, to discuss the discontinuation of products. Such a forum would certainly be a worthwhile development.

Although not a perfect alternative (the cost of individually compounded medication will be higher), prescribers will now be aware that all is not lost if an effective treatment is removed from the marketplace.

Alan Hewitt
General manager
Stenlake Compounding
Bondi Junction, NSW