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Benefit of statins depends on genes

The Government's ill-advised promotion of over-the-counter sales of powerful drugs, with serious and potentially fatal risks when improperly used, amounts to the release of safe and effective products into an unsafe and ineffective environment1.

This is because the safe and effective use of drugs depends on accurate diagnosis and full knowledge of past medical history and current medication. Pharmacists' diagnostic skills are limited, usually based on history-taking, and they often lack any information on the second and third items.

While I was a member of the Committee on Safety of Medicines I tried several times to oppose down-licensing on these grounds and, on each occasion, was in a minority of one.

Over the next few years I predict we shall see the rise of a new disease category – apothecogenic illness – to add to the existing one of iatrogenic disease, and this new disease phenomenon will be the result of present Department of Health policy, supported by the MHRA, which may be no more independent of the Government than any of our 'agencies'.

What is being done is not safe, not rational and not in the public interest. The only justification seems to be a financial one, as your article suggests (News, June 21).

If extending OTC drug sales is bad policy then public advertising of drugs is mad policy! It will create intense pressures on GPs to prescribe drugs that may be no better, but more expensive, than the patients' existing treatment, or drugs that may not be needed at all.

Experience in the US shows that direct advertising of drugs increases the total medication spend nationally. The only beneficiaries are the drug producers.

Professor Hugh McGavock

Consultant in Prescribing Science

Cloughmills, Co Antrim

1. Hepler CD, Segal R. Preventing medication errors and improving drug therapy outcomes. CRC Press, Boca Raton, London, New York, Washington DC. 2003, P4

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