Drug manufacturers very much work according to the maxim of ‘Waste not, want not’. Take thalidomide, for instance – and, in fact, many people in developing nations still do.
Or how about the non-steroidal, anti-inflammatory drug (NSAID) nimesulide? The drug has been linked to liver damage, and has been refused a licence in the US, Europe, Canada and Australia. Last year, it was banned in Turkey, Finland and Spain. But it’s good enough for the Indian market, where it has been sold with impunity since 1994, when it was granted a licence. In fact, it’s been quite a success and isn’t being used just for arthritic conditions, for which it was intended, but is also prescribed as a painkiller and for treating fever.
So, how many Indians have been harmed while on the drug? Nobody seems to know, but a committee has been set up to look into it.
So, that’s alright then (BMJ, 2003; 326: 70).