400 



warnings, manufacturer, generic and brand names, and facts about their safety 

 and effectiveness."^ 



Similarly, the FDA task force on prescription drugs recommended, 

 August 30, 1968, that the Secretary of Health, Education, and Wel- 

 fare should be "authorized to publish and distribute a drug compen- 

 diiun listing all lawfully available pi-escription drugs, including such 

 information as available dosage forms, clinical efiects, indications and 

 contraindications for use, and methods of administration, together 

 with price information on each listed product." ^^'* 



On the other hand. Medical World News reported, August 16, 1968, 

 that the Pharmaceutical Manufacturers Association was '"cool to the 

 idea" and, as a result of a personal survey of physicians, had found 

 that 82 percent said that Physicians' Desk Reference was the com- 

 pendium ''they used most often for drug information.'' (Second choice 

 was "personal experience.") The survey had been conducted for P^IA 

 by Opinion Eesearch Corp.^^^ The report, incidentally, made reference 

 to the "7,000 or so drugs now available," and to "the top 600 drugs, 

 which account for about 90 percent of all prescriptions written." 



A series of articles in the Medical Tribune, by Joseph D. Cooper, a 

 professor of political science at Howard University, explored in some 

 depth the pros and cons of such a compendium, and concluded that 

 for the collection to be of greatest usefulness it should be computerized 

 with tape copies widely accessible to physicians, so that individual 

 entries could be called out as needed.^^^ The article presumed the rapid 

 increase in accessibility and utilization of computerized information 

 sources. 



Report on hlochemicnl meclianisvi of phoconielki from thalidomide 

 Before the American Chemical Society, at its annual meeting, 

 September 12, 1968, Dr. Heinz M. Wuest, a New York chemist and 

 consultant to the Sloan-Kettering Institute for Cancer Research, de- 

 scribed research findings concerning the "teratogenic effects" (deform- 

 ing of the fetus) of thalidomide. The mechanism, he said, involved the 

 presence in the molecule of two particular acid radicals — those of 

 phthalic acid and glutamic acid. He noted that glutamic acid, or 

 "glutamine" is a common ingredient of many foods, but that phthalic 

 acid was an extremely uncommon ingredient of chemicals for human 

 use, and that both had to be present in the same molecule to cause the 

 teratogenic efiects. Dr. Wuest expressed the belief that "no one could 

 have predicted" the thalidomide disaster, and that "tools are nov,' 

 available" to prevent a recurrence of such an event.^^'^ 



A"II. The Continuing Problem of Securing and Using Scientitic 



Guidance on Drug Issues 



The thalidomide episode provided a climax in a continuing congres- 

 sional study of public issues related to prescription drugs. It diverted 



""U.S. President (Lyndon B. .Johnson). "Health in America." "The President's Messagre 

 to the Congress Including Five New Ma.ior Goals in His Recommendations." Mar. 4, 1968. 

 Weelily compilation of Presidential Documents. (Mar. 11, 1968, vol. 4, No. 10), pp. 4.31-2. 



1" Task force on prescription drugs, second interim report and recommendations, op. cit., 

 pp. vil-viii. 



UK "FDA and Doctors Clash on Compendium," Medical World News, Aug. 16, 1968, vol. 9, 

 p. 17. 



ii« The series of five articles were reproduced in sequence in the Congressional Record, 

 Nov. 1, 1968. pp. 9804-9809. 



^'^ Richard D. Lvons, "Thalidomide Effects Are Linked to Acids in Molecule of Drug," 

 New York Times (Sept. 13, 1968), p. 30. 



