January 13, 2005
No Such Thing as a Safe Drug
By Russell Roberts

The truth is, there’s no such thing as a safe drug. Every drug has side effects. It’s only a matter of degree. And there’s usually a tradeoff between safety and effectiveness. Powerful drugs are more likely to have side effects. Everyone who undergoes chemotherapy understands that life is about tradeoffs—about the likely costs and likely benefits.

Cautiousness is always in order when you introduce a powerful drug into your body. You don’t want to die from a dangerous drug. But you also don’t want to suffer or die because the right drug is not available.

In this world of imperfect safety, why do we give the FDA the authority to make these choices for us? The FDA is the ultimate one size fits all solution. If arthritis makes my life a living hell, why can’t I decide to take on a greater risk of a heart attack? The choice between pain and risk should belong to me and my doctor.

Instead we are heading in the wrong direction, demanding that the FDA become even more cautious and careful in protecting us from harm. If FDA approval is harder to get, then drugs will be safer. But the unintended consequence will be to make it harder to get FDA approval for drugs that can save lives. The unintended consequence will be losing the drugs that we won’t discover because it’s simply too expensive to go looking for anything other than a blockbuster.

Those costs are in the future. But some of the unintended consequences have already appeared. Vioxx has shown promise fighting colon cancer. But clinical trials using powerful painkillers to fight cancer and Alzheimers are now at risk, all the findings and benefits potentially wasted.

Russell Roberts is Professor of Economics and the J. Fish and Lillian F. Smith Distinguished Scholar at the Mercatus Center at George Mason University. This article is from NPR's Morning Edition.

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