Comparing Risks from Drugs with Other Risks

Determining the true risk of a particular action – taking a medication, working in a dangerous job, or taking an automobile ride – are difficult to compare. However, when such comparisons have been done, one sees that medications don’t show up as badly as the media would have us believe. A publication in the journal Health Affairs makes this point; it has been summarized in a very readable form in Bandolier, a British online health journal.  

The risk of death per 100,000 person years was calculated for several medications, occupations, and modes of travel. This risk for taking aspirin daily by a 50-year-old to prevent heart disease, being a firefighter, and traveling in an automobile were all about the same: 1 in 9,000 to 9,500.

Taking rofecoxib (Vioxx®) yielded a risk of 1,300 deaths per 100,000 person years, based on a study of its potential use in preventing colon cancer. This drug was withdrawn from the market in 2004, because of its tendency to cause cardiac deaths. Being a truck or taxi driver carries about half this risk: one in ~2,500 per 100,000 person years. Adding some perspective, air transport carries a death risk of 1 in 650,000 person years vs. riding a motorcycle’s 1 in 222 person years.

All the activities analyzed carry benefits, which are extremely hard to quantify. This renders decision-making comparisons (based on a benefit:risk ratio consideration) virtually impossible to compare. Just don’t go out and buy a motorbike unless the pleasure is really, really great!