§ Mr. Ashley
asked the Secretary of State for Social Services, pursuant to the answer of 6 March, Official Report, columns 499–500, if he will list the non-steroidal anti-inflammatory drugs in rank order according to the number of prescriptions issued for each one in the last year for which figures are available; and if he will give for each (a) the number of reported adverse reactions, from all sources, per million prescriptions and (b) the number of deaths reported as associated with each, expressed as the number per million prescriptions.
§ Mr. Kenneth Clarke
Listed is the total number of adverse reactions received in 1982 to the drugs named and the number of deaths included in that total. They have not been expressed as an incidence per million prescriptions since this would be wholly misleading. This is because only five drugs achieved one million prescriptions in 1982 and nine achieved less than 200,000 prescriptions. It would be quite artificial to multiply up by a large factor the numbers of adverse reactions reports to provide an incidence of reactions per million prescriptions. The drugs are arranged in descending order of the number of prescriptions issued in 1982.
Number of adverse reactions Number of deaths Ibuprofen 89 2 Indomethacin 137 13 Naproxen 186 7 Piroxicam 449 10 Mefanamic Acid 87 3 Phenylbutazone 38 6 Flurbiprofen 81 6 Diclofenac Sodium 106 2 Fenoprofen 31 1 Diflunisal 46 2 Ketoprofen 46 4 Oxyphenbutazone 11 1 Azaproprazone 98 2 Sulindac 37 0 Tiaprofenic Acid 130 0 Feprazone 92 0 Fenclofenac 75 0
Number of adverse reactions Number of deaths Fenbufen 632 2 Tolmetin 2 0 Flufenamic Acid 3 1 Indoprofen 97 3
I have provided the information for which the right hon. Member asked in so far as this was possible. I must however emphasise that use of the table to compare information relating to individual substances is likely to be very misleading indeed. First, a report on adverse reaction or death associated with a drug does not necessarily indicate a causal relationship between the drug and the reaction. In addition, the table cannot be used to assess the risk-benefit ratio of a drug. The information relates only to one year. It does not differentiate at all in non-fatal reactions between minor, reversible, symptoms and more severe conditions. It takes no account of the special benefits which may be associated with any drug. All these factors and others have to be considered before we can take a sensible decision about the continued licensing of a product.