The science of health technology assessment: the safety perspective

Efforts to enhance the reporting and analysis of drug reactions have increased over recent years. Research into the pathogenesis, diagnosis and epidemiology has yielded important insights, yet major gaps in our management of drug safety still exist. Drug-induced diseases are an important cause of morbidity and mortality. Current ad hoc reporting systems fail to collect more than 10% of even the most serious of reactions. Drug reaction syndromes lack universally accepted definitions and names. Effective therapies for drug-induced diseases are few and poorly studied. Information about how to diagnose and treat drug-induced diseases is not reaching practitioners. Stakeholders, including regulatory agencies, funding agencies, the pharmaceutical industry, physicians, pharmacists and patient advocacy groups, need to work together to improve the systematic approach to drug safety and to make all stakeholders aware of advances in the technology surrounding drug-induced disease. The technology is available to make major strides in improving the overall management of drug-induced disease. The major barrier to progress is the lack of leadership from any of the powerful sectors involved in drug use.