As a result of the practolol experience, it was recognized that other active efforts were required to identify adverse reactions more consistently than is possible with passive voluntary systems. In particular, proposals were put forward for approving a drug for marketing on a conditional basis, during which time its use would be actively monitored for serious and uncommon adverse drug reactions. Special enthusiasm existed for such methods in the United Kingdom because there were interested individuals and the centralized processing of all prescriptions by the Prescription Pricing Authority provided a population-based source of data. Four schemes were proposed in 1977. Inman’s recorded release, Dollery and Rawlins’ registered release, and Lawson and Henry’s monitored release schemes appeared in the early part of the year, and in October, 1977, Wilson who was from the Association of the British Pharmaceutical Industry, proposed a simpler method. A revised version of this was put forward by the Committee on Safety of Medicines in 1978.
Although a small trial of recorded release was performed, none of the proposals were put into practice in the United Kingdom except Wilson’s , which was developed into prescription-event monitoring in the early 1980s. Prescription-event monitoring was one of the first methods to identify cough and angioedema as adverse effects of enalapril and was able to quantify the rates of occurrence , as well as investigate the role of enalapril in deaths after renal failure. In New Zealand, a scheme similar to Lawson and Henry’s proposal, known as the Intensive Medicines Monitoring Programme, was established in 1977. This program has identified a large number of signals of potential adverse reactions, including myalgia/myositis withbezafibrate, gemfibrozil and simvastatin , and convulsions, dystonia and hepatotoxicity with fluoxetine as well as interactions between fluoxetine and several cheap drugs. The Intensive Medicines Monitoring Programme was one of the earliest programs to detect the association between chest pain and sumatriptan.