Affiliations: Emergency Department, University Health Network, School of Health Policy and Management, York University, and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Note: [] Address for correspondence: Dr. Joel Lexchin, 121 Walmer Rd., Toronto, Ontario, Canada M5R 2X8. Tel. +1 416 964 7186; Fax: +1 416 923 9515; E‐mail: joel.lexchin@utoronto.ca.
Abstract: New drugs are frequently heavily prescribed early in their lifecycle, despite an absence of adequate data documenting their effectiveness, safety and pharmacoeconomic value. Evaluations of new drugs done in Canada, France and the United States are all in substantial agreement that most new medications offer little, if any, incremental value over existing therapies. The combination of inadequate information about new drugs plus their limited value strongly argues against their early use except in exceptional circumstances. One of the major reasons for overuse of new drugs is heavy promotion by pharmaceutical companies, especially through their sales representatives. Better control over the activities of this group of people is one method of improving use of new drugs. Equally important is the development of a significantly improved system of postmarketing surveillance and evaluation. At present, the Canadian government seems unwilling to both rein in promotion and commit resources to an effective postmarketing system.
Keywords: Canada, drug approval process, effectiveness, new drugs, pharmacoeconomic evaluation, postmarketing surveillance, promotion, safety, sales representatives
