Although drug development is overly cumbersome, once developed drugs are generally successfully deployed and used.

Judge as of 2015-08-17. The claim has two parts: (a) drug development is overly cumbersome; (b) once approved, drugs are generally deployed and used successfully. Part (a) is largely a value judgment, so the test turns mainly on (b). True: health-policy or pharmaceutical evidence from around 2015 shows that most approved drugs reach clinical use and uptake, with access, pricing and adherence problems being exceptions rather than the rule. Mostly true: uptake is generally good, but there are notable documented gaps (e.g. slow diffusion, access barriers in poorer countries, poor adherence) that the claim glosses over. Mixed: the evidence shows uptake is good in some settings or drug classes and poor in others in roughly equal measure. Mostly false: a real point about relative uptake is overstated, and major research shows slow diffusion, underuse, non-adherence or lack of access are widespread. False: evidence shows most approved drugs are not successfully deployed or used.

Set before the research began.

1. E1 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (PMC); the journal is not named in the fetched text · 22 April 2014

   “In the United Kingdom, The UK Children's Cancer Study Group [49],[50] followed up children with testicular cancer from 1979 to 1988, during which period only about 7 % of patients received the drug.”

2. E2 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (PMC); the journal is not named in the fetched text · 22 April 2014

   “One study from the Netherlands found that cisplatin was not in widespread use between 1970 and 1978 [48] (Table 3).”

3. E3 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (PMC); the journal is not named in the fetched text · 22 April 2014

   “A previous review have found that the mean compliance rate for guidelines was 54% 3 years after the publication.”

4. E4 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (PMC); the journal is not named in the fetched text · 22 April 2014

   “The continued implementation of treatment was verified by sales statistics in all countries.”

5. E5 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (NCBI); journal not named in the fetched text · 22 April 2014

   “For instance, pharmaceuticals may have been used in clinical trials before registration year (which may have a considerable impact if trials are relatively large and the condition is rare), or there may have been a delay after the registration year before the drug is widely adopted.”

6. E6 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (NCBI); journal not named in the fetched text · 22 April 2014

   “In the United Kingdom, The UK Children's Cancer Study Group [49],[50] followed up children with testicular cancer from 1979 to 1988, during which period only about 7 % of patients received the drug.”

7. E7 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (NCBI); journal not named in the fetched text · 22 April 2014

   “The continued implementation of treatment was verified by sales statistics in all countries.”

8. E8 The timing of introduction of pharmaceutical innovations in seven European countries PubMed Central (NCBI); journal not named in the fetched text · 22 April 2014

   “Several modifiable reasons have been found for not using proven pharmaceutical interventions, including clinician, patient and system factors [83].”

9. E9 Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders PubMed Central (retrospective cohort study, integrated health system) · 31 August 2011

   “The proportion of primarily non-adherent patients varied by therapeutic class, including 7% of patients ordered an antihypertensive, 11% ordered an antidiabetic, 13% ordered an antihyperlipidemic, and 5% ordered medications from more than one of these therapeutic classes within the study period.”

10. E10 Characteristics of Patients with Primary Non-adherence to Medications for Hypertension, Diabetes, and Lipid Disorders PubMed Central (retrospective cohort study, integrated health system) · 31 August 2011

    “Both our findings and those of Karter et al. differ markedly from those of Fischer and colleagues where a primary non-adherence rate of 22.5% was found.”

E9 reports that, in one integrated health system, 7% to 13% of patients newly ordered a drug in a given chronic-disease class were primarily non-adherent, so most of these patients were not. E7 reports that sales statistics confirmed continued use of the studied drugs in all seven countries. The same sources also document real gaps. E1 and E2 report low uptake of a cancer drug in specific periods: about 7% of UK children with testicular cancer received the drug in 1979–1988 [E1], and cisplatin was not in widespread use in the Netherlands in 1970–1978 [E2]. E3 reports mean guideline compliance of only 54% after three years, and E5 and E8 describe delays in adoption and clinician, patient and system barriers to using proven drugs. Overall, uptake looks broadly good but with notable documented gaps that the claim glosses over, which matches the mostly-true criterion. The evidence is limited, though, and does not directly measure uptake across all approved drugs.