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Healthy Skepticism Library item: 6188

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Di Paolo ER, Stoetter H, Cotting J, Frey P, Gehri M, Beck-Popovic M, Tolsa JF, Fanconi S, Pannatier A.
Unlicensed and off-label drug use in a Swiss paediatric university hospital.
Swiss Med Wkly 2006 Apr 1; 136:(13-14):218-22
http://www.smw.ch/dfe/set_archiv.asp?target=2006/13/smw-11275


Abstract:

BACKGROUND: Many medicines used in newborns, infants, children and adolescents are not licensed (“unlicensed”) or are prescribed outside the terms of the marketing authorization (“off-label”). Several studies have shown that this is a common practice in various healthcare settings in the USA, Europe and Australia, but data are scarce in Switzerland. OBJECTIVES: The aim of our prospective study was to determine the proportion of unlicensed or off-label prescriptions in paediatric patients. METHODS: This pilot study was conducted prospectively over a six month period in the department of paediatrics of a university hospital. RESULTS: Sixty patients aged from three days to 14 years were included in the study. A total of 483 prescriptions were written for the patients. More than half of all prescriptions (247; 51%) followed the terms of the marketing authorization. 114 (24%) were unlicensed and 122 (25%) off-label. All patients received at least one unlicensed or offlabel medicine. CONCLUSION: The use of unlicensed or off-label medicines to treat children was found to be common. Co-operation between the pharmaceutical industry, national regulatory authorities, clinical researchers, healthcare professionals and parents is required in order to ensure that children do not remain “therapeutic orphans”.

Keywords:
Adolescent Child Child, Preschool Drug Approval* Drug Labeling* Female Hospitals, Pediatric Hospitals, University Humans Infant Infant, Newborn Male Pharmaceutical Preparations* Physician's Practice Patterns/statistics & numerical data* Pilot Projects Prospective Studies Research Support, Non-U.S. Gov't Switzerland

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909