Communicating the risks and benefits of medicines.

Pharmaceutical innovation, together with rising education, sanitation and wealth, prolonged life expectancy in industrialised countries throughout the 20th century. At the turn of the 21st century, with many, formerly common, lethal diseases confined to the developing world, the benefits of medical intervention are taken for granted in industrialized countries, and the expectations of safety have risen considerably. The perception and tolerance of risk has changed largely in the absence of immediate, population-wide health threats. Here, we review selected examples of drug withdrawals and adverse drug effects, and their impact on public perception. We analyse the role of major players, such as the media, patients, prescribers, regulators and pharmaceutical companies, and what actions are needed to better describe and communicate the risks and benefits of medicines to the public.