- Medicine Information and Evidence for Policy > Information and Publications
- Medicine Access and Rational Use > Rational Use
(2005; 165 pages)
3.2 The history of drug bulletins
Drug bulletins began to appear around 1960, at a time when pharmaceutical research leading to the introduction of new drugs had begun to revolutionise the practice of medicine. This was also the time of the thalidomide disaster, which forced the world to pay serious attention to the harm that drugs might cause.
Medical, pharmacy, nursing and other health journals for health professionals have always published articles about drugs and other medical treatments, but such articles have to compete with a mass of other material. The result remains a rather haphazard coverage of therapeutics in both general and specialist journals. Through their practical orientation, drug bulletins fill a special need: to provide information in a way that helps practitioners make informed decisions about the use of pharmaceuticals.
The growth in importance of the pharmaceutical industry during the 1950s and 1960s was accompanied by a large increase in drug advertising. An increasing number of thoughtful and critical doctors wanted to be better informed about drugs, especially new drugs, and needed independent assessments of manufacturers' claims. The 1960s also marked a time in which a growing consumer rights movement became increasingly active in health policy. The earliest drug bulletins were published by consumer organizations although their readers were almost all doctors. This is still the case for several large, successful, national bulletins and no doubt reflects a recognition by consumer groups that independent prescribing information for doctors can help to contribute to better health services.
The first drug bulletin, The Medical Letter on Drugs and Therapeutics, was started in the USA in 1959 by Harold Aaron, a physician who had been medical adviser of Consumers’ Union (CU), itself the world's oldest consumer organization, and Arthur Kallet who had been the director of CU. In 1962 it was adapted for prescribers in the United Kingdom (UK) as the UK edition of the Medical Letter, published by the Consumers' Association, and a year later this became the separate Drug and Therapeutics Bulletin. At the same time the Ministry of Health in the UK began to publish Prescribers’ Notes for doctors working in the National Health Service, which later became Prescribers' Journal (no longer published).
One can guess why this activity started in the USA and in the UK. At that time American pharmaceutical companies were producing more new drugs, were marketing them more aggressively, and had a larger domestic market than companies elsewhere, so a critical mass of doctors perceived a need for independent information earlier than in other countries. Britain was unique in having a National Health Service that paid for all medicines. The Government thus had a strong reason for wanting to improve the quality of prescribing, to get better value for the large expenditure on drugs.
In the next 30 years many more drug bulletins were started in various European countries and also in Australasia, Asia, Africa and Latin America. Now between 50 and 100 bulletins are published worldwide - the exact number depends on the definition used. These bulletins differ greatly in their target groups and circulation, their scope, size and frequency, the method of production and style of presentation, the teams producing them, their links to institutions and organizations, and how they are funded. One perhaps unexpected aspect of this diversity is that in some countries (e.g. Germany, Italy, Spain) several bulletins exist side by side, addressing different though sometimes overlapping readerships and sometimes specialising in different topic areas.