The assessment of risks, benefits and availability of non-narcotic analgesics. A commonsense approach.

Abstract

In Indonesia, about 50% of all available non-narcotic analgesics are marketed as single drugs and the other half comprise fixed combination products. Each country should decide through a national drug policy which drugs are to be available, but it is important such policies be flexible and cognisant of the needs of the public and of the pharmaceutical industry. A drug should not be withdrawn from the market without an objective scientific assessment of its benefit-risk ratio. However, reevaluation of some drugs marketed previously should be undertaken, including combinations of non-narcotic analgesics. Although it is often said that evaluation of drugs should be left to experts in the established drug control agencies and that the third world countries should follow their decisions, there is a good argument for the developing countries to formulate and implement their own drug policies. In evaluating a non-narcotic analgesic, efficacy and safety must be carefully considered and a drug with marginal efficacy should not be approved for use. However, a non-narcotic analgesic with superior efficacy should probably be approved for use even if there is some risk associated with usual therapeutic dosages. Commonsense reasoning demands that drugs should be for the layperson to treat common ailments, although such drugs must fulfil exacting criteria of efficacy, safety and simplicity of use.