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In an article in iNews some British experts have called, among other things, for an enquiry into the overuse of prescription drugs:

Leading British health experts are calling for a Chilcot-style inquiry into why they say tens of thousands of people continue to die every year through the overprescription of drugs.

They argue that (my emphasis):

Overprescribing medications is now thought to be the third most common cause of death after heart disease and cancer, which kills around 125,000 and 150,000 people a year in the UK respectively.

There is no particular reason to assume this is a problem unique to the UK. But some experts are skeptical of the large and often reproduced numbers of deaths from medical errors.

Are the high estimates right? Is overuse of prescription drugs now a leading cause of death in advanced countries?

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    Note that they say "now thought". This means that if Frank Bupkis in that shack over by the stockyard thinks it's true then their statement is true. – Daniel R Hicks Apr 12 '18 at 12:20
  • @DanielRHicks The question isn't whether somebody thinks this is true, the question is whether there is any evidence it is true. – matt_black Apr 12 '18 at 12:33
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    I would caution against extrapolating causes of deaths between countries. For instance, automotive deaths are much more common in the U.S. than in the U.K, since a lot more people drive in the U.S. – alexgbelov Apr 16 '18 at 19:34
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The German Federal Statistics Office (''Statistisches Bundesamt'') listed the causes of deaths in Germany for 2015 sorted by ICD-10 chapter as follows (sorted most to least common, chapter headings translated by me):

  • diseases of the circulatory system (chapter IX, 354,493)
  • tumors (chapter II, 230,840)
  • diseases of the respiratory system (chapter X, 64,918)
  • diseases of the digestive system (chapter XI, 40,112)
  • mental and behavioral disorders (chapter V, 36,117)
  • injuries, poisonings, and specific other results of outside causes (chapter XIX, 34,133)
  • endocrinal, nutritional, and metabolic diseases (chapter IV, 31,197)
  • diseases of the nervous system (chapter VI, 25.792)
  • symptoms and abnormal clinical and laboratory results not otherwise categorized (chapter XVIII, 25,189)
  • diseases of the urogenital system (chapter XIV, 21,888)
  • specific infectuous and parasitic diseases (chapter I, 18,475)
  • diseases of the musculoskeletal system and connective tissue (chapter XIII, 3,524)
  • diseases of the blood and blood-producing organs, plus specific defects including the immune system (chapter III, 2,916)
  • birth defects, deformities, and chromosomal anomalies (chapter XVII, 1,706)
  • diseases of the dermis and subdermis (chapter XII, 1,374)
  • adverse perinatal outcomes (chapter XVI, 1,117)
  • pregnancy, birth, and childbed (chapter XV, 29)
  • diseases of the ear and the mastoid process (chapter VIII, 29)
  • diseses of the eye and ocular adnexa (chapter VII, 9)

I note three things here:

  • Heart diseases (circulatory system) and cancer (tumors) are right there at the top of the list.
  • The third item of the list are diseases of the respiratory system, not anything medication-related.
  • It remains completely unclear what, and how, the authors grouped under the heading of "overprescribing of pharmaceuticals" in the first place, but no likely ICD chapter candidate shows up in the top five of this listing.
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    The trouble is that ICD10 doesn't have a category for classifying deaths that happen earlier because of issues with medication. So deaths from overuse of beta-blockers (a well known example) would actually come under diseases of the circulatory system. Therefore analysis of ICD10 at primary cause of death level won't provide any useful information on the effects of overprescribing. – matt_black Apr 12 '18 at 12:15
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    There is a certain weakness in coding observable. Take liver-blaster paracetamol: is this F55.2, T39, T78, Y57, acute or chronic, iatrogenic or changed over to selfprescrbed. -> Many of these codes need aggregation to match the claim (proving or disproving it) – LаngLаngС Apr 12 '18 at 12:15
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    @LangLangC: Yes, but unless the authors of the linked article make their methodology of categorizing "overprescription deaths" public, theorizing about it would be OR, wouldn't it? ;-) – DevSolar Apr 12 '18 at 12:17
  • I have seen at least two cases where, in my judgment, dehydration was misdiagnosed as COPD or asthma and the subsequent use of decongestants led to further dehydration and death. – Daniel R Hicks Apr 16 '18 at 12:15
  • @DanielRHicks: But that's 1) anecdotal, and 2) in your judgement. I don't say you're wrong, I just say that, between statistics and presentation, you can claim a lot... – DevSolar Apr 16 '18 at 12:17

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