ROANOKE TIMES
Copyright (c) 1995, Roanoke Times
DATE: Sunday, December 10, 1995 TAG: 9512080032
SECTION: BUSINESS PAGE: G-1 EDITION: METRO
DATELINE: TRENTON, N.J.
SOURCE: LINDA A. JOHNSON ASSOCIATED PRESS
THE PHYSICIANS' DESK REFERENCE has changed along with the times and the pharmaceutical industry.
Doctors were still prescribing arsenic and strychnine for nervousness, "melancholia," low sex drive, even anemia during pregnancy, when the first Physicians' Desk Reference appeared a half-century ago.
Back then, there were no polio vaccines, no blood-clotting products for hemophiliacs and only eight drugs listed for cancer. Dozens of products were listed for sexual disorders, most containing extracts of ovaries, testicles or prostates, but contraceptive choices were limited to diaphragms, spermicidal creams and condoms.
New drugs and better research have since revolutionized the pharmaceutical industry - and the PDR, the country's largest annual medical reference book.
Publisher Medical Economics Co. of Montvale, N.J., recently issued the 1996 PDR, its 50th edition, and is marking the anniversary with something old and something new: a PDR Electronic Library on CD-ROM for Windows, complete with graphics, and an old-fashioned-looking, commemorative reprint of the first PDR.
The latter provides a fascinating, even amusing look at the state of medicine at mid-century and shows how far the science has come since 1947 - when cod liver oil was used for everything from nutritional problems to treating wounds, and tablets made from dried hog kidneys were prescribed for people thought to be "allergic" to cold, heat and light.
"It's kind of a reflection on what's happened to the U.S. pharmaceutical industry in these 50 years," said Thomas F. Rice, president of Medical Economics' Drug Information Services Group.
The PDR has changed along with the industry, and now also is available in electronic pocket and CD-ROM versions.
The book has grown from 380 pages briefly describing some 1,500 items to nearly 3,000 pages with detailed descriptions of more than 3,300 drugs and diagnostic products. There are some 1,900 color photos, numerous line drawings and diagrams of drugs' chemical structures, and twice-yearly supplements.
And PDR's cover no longer states "For the Physician's Desk Only" because its audience has changed, too.
Nearly 600,000 copies of PDR are sold annually, at $65 apiece, to hospitals, clinics, nurses, dentists, veterinarians, libraries, government and other agencies - and the public.
About 125,000 consumers now buy PDR in regular bookstores as more and more families check on their prescriptions. In addition, the company in 1993 started putting out "Family Guides" to prescription drugs, nutrition and women's health.
Another half-million PDRs are given free to every U.S. office-based physician. The Food and Drug Administration requires drug makers to notify doctors about their products, so pharmaceutical companies pay to have their information included in the book.
The 1947 edition included some entries that read more like advertising than reference material. Many items were not even scientifically prepared, but "nostrums" - compounds of a secret composition whose makers touted them as effective or useful without any proof they worked.
But by 1970, every entry met FDA rules that the wording be exactly what the agency approved for the product label and package insert.
Today, product descriptions include lengthy explanations of the drugs' chemical structure, how they work, conditions for which they are used, dosage and administration. Also included are warnings about possible adverse reactions or drug interactions and whether the medicine can be used by children, pregnant women or nursing mothers.
The one thing missing: prices.
"It used to be enough for a doctor to make the best clinical decision for a patient," but with the spread of health maintenance organizations and other managed care networks, cost also must be considered, Rice says.
So this year, the company published the first PDR Generics, combining prescribing and price information on virtually every brand-name prescription drug and its less-expensive generic alternatives.
Another Medical Economics product, called "Drug Topics Red Book," also includes pricing and prescription information, but is targeted to pharmacists, insurers and managed care operations.
Medical Economics, a trade magazine with annual sales of nearly $400 million, also publishes reference books, journals and newsletters for specialty physicians, nurses, veterinarians, dentists, eye doctors, health care administrators and the biotechnology industry, along with medical publications in Spanish and Italian. Some are also available as electronic pocket books or on CD-ROM.
LENGTH: Medium: 88 lines ILLUSTRATION: GRAPHIC: Chart by AP: Mid-century medicine. color.by CNB