To the Editor.—
Talley and Laventurier stated that their earlier estimate of 30,000 deaths annually in the United States due to adverse drug reactions (ADRs) was too low, and that on the basis of new evidence, the number of such deaths ranges from 60,000 to 140,000 annually.The matter is of particular concern to the prescription drug industry since it has been suggested that companies, through overpromotion, are responsible for these deaths and hospital admissions.An attempt to trace the history of the 30,000 ADR death estimate, to review the pertinent literature, and to substantiate the 3,000 to 6,000 estimate follows.The issue has two parts: How many deaths occur annually because of adverse drug reactions, and to what extent can they be attributed to "promotional activities of the drug industry"?
Background.—
The history of the 30,000 statistic is convoluted. In a paper presented in August 1972 at Sea Island,