Bibliometric analysis of Naunyn-Schmiedeberg's Archives of Pharmacology (1947-1974).

Naunyn-Schmiedeberg's Archives of Pharmacology is the oldest pharmacological journal, founded in 1873. This bibliometric analysis examines the pivotal transformations within Naunyn-Schmiedeberg's Archives of Pharmacology from 1947 to 1974, identifying significant shifts from a national focus to a period of extensive internationalization and English-language adoption. Employing Python and Beautiful Soup for data extraction from SpringerLink, the study maps the journal's trajectory through post-World War II development, highlighting the decline in publication rates due to its initial emphasis on German-language articles predominantly from Germany. The transition towards English publications in the late 1960s is marked as a turning point, catalyzing an increase in global citations, publications, and recognition. This period witnesses the journal broadening its scientific horizon, with a notable emphasis on the cholinergic, adrenergic, and dopaminergic systems, reflecting their central role in the journal's scientific discourse and citation prominence. The analysis demonstrates how shifting to English for academic publishing played a crucial role in revitalizing the journal's impact and visibility on the international stage.

Bibliometric comparison of Nobel Prize laureates in physiology or medicine and chemistry.

The Nobel Prize is an annual honor awarded to the researchers who have made the greatest contribution to humanity with their work in the year in question. Nobel Prizes for physiology or medicine and chemistry most often have direct or indirect pharmacological relevance. In this study, we performed a bibliometric analysis of Nobel Prize laureates from 2006 to 2022. The parameters include the nationalities and age of the laureates, age at their productivity peaks, the research locations, the H-index, the age-adjusted H-index, and the number of citations and publications, and, for each parameter, a comparison of female and male award laureates. Men were much more often awarded the Nobel Prize than women. Surprisingly, women were younger than their male colleagues at the time of the award although the productivity peak was similar. There was a correlation between all publications and the H-index, which was slightly stronger for women than for men. The age-adjusted H-index showed no difference among genders. The USA were the country with the highest number of Nobel Prize laureates, both male and female. Overall, the bibliometric characteristics of male and female Nobel Prize laureates are similar, indicating that among the group of Nobel Prize laureates, there is no bias against women. Rather, the achievements of women are recognized earlier than those of men. The major difference is that the number of women becoming Nobel Prize laureates is much smaller than the number of men. This study provides a starting for future studies with larger populations of scientists to analyze disparities.

Presentation of pharmacological content in crime novels between 1890 and 2023.

As there is lack of research on how drugs are presented in crime literature, we read nearly 25,000 pages of crime literature written between 1890 and 2023 to provide an overview on the pharmacological content in this genre. Correct presentation of pharmacological information decreased over time. Misconceptions about certain substances, especially narcotics and anesthetics appear in many of the analyzed examples. Also, in comparison with crime TV series, books are inferior in providing the reader with additional information and pharmacological plausibility. This especially applies for the newer books which contained less additional information than the older ones. In contrast, some books educate their readers. Newer books show a greater variety of substances also introducing recently developed drugs or new ways of application. On the contrary, older books stick to a small selection of well-known substances during that time, especially metals like arsenic and toxins like strychnine. Gender involvement in poisoning is not realistically presented in the novels. Male victims are overrepresented compared to reality. Also, the etiology is commonly presented incorrectly. Poisoning by accident or for suicidal purposes are rarely presented in the novels, despite their significance in reality. Overall, crime novels educate but also misinform their readers. We discuss the consequences of our findings for the individual reader and public health.

Vitamin A-containing dietary supplements from German and US online pharmacies: market and risk assessment.

Vitamin A supplements are used by many people, and the number of newly registered dietary supplements is continuously increasing. The preparations fall under food law and are not subject to the strict controls of pharmaceuticals. Risk indications and maximum quantity recommendations, e.g., from the Bundesinstitut für Risikobewertung (BfR) and the U.S. Food and Drug Administration (FDA) are not binding, which means that overdoses and potentially serious health problems can easily occur. The hepatotoxicity and teratogenicity of vitamin A are well documented, and other negative effects of high doses of vitamin A are also being discussed. Nevertheless, preparations with exorbitantly high doses are freely available for sale and unrestricted. In this study, 75 supplements containing vitamin A available in Germany and 26 available in the USA were critically examined on the basis of various parameters such as the recommended daily dose according to the manufacturer, daily therapy costs (DTC), the presence of warnings about overdose, use during pregnancy and breastfeeding, and information on adverse effects/interactions. The aim was to gain insights into their risk potential and to examine the need for closer monitoring and stricter guidelines for these preparations. The results show some considerable country-specific differences. Overall, there are serious deficiencies in compliance with the labeling requirements for both the German and the US preparations, and the dosages are often far too high in view of the applicable expert recommendations. Overall, these deficits can pose a risk for consumers that is difficult to assess in its entirety, especially for vulnerable consumer groups. It should be noted that the US preparations perform better overall than the German preparations. This suggests better regulation of dietary supplements in the US market. Based on the available data and literature research, it is doubtful whether the intake of vitamin A-containing preparations, without a diagnosed vitamin A deficiency, has a positive health benefit. Furthermore, it should be examined whether vitamin A should continue to be offered over-the-counter as a food supplement.

Pharmacological articles in the German magazine DIE ZEIT (THE TIME)-content, adequacy, and comprehensibility.

The German weekly magazine DIE ZEIT (THE TIME) reaches more than one million readers per issue, mainly from high-income social classes. Pharmacological content is frequent in DIE ZEIT. As it therefore reaches many people who generally have no in-depth knowledge of pharmacology, it can be assumed that DIE ZEIT is an important primary source of information. It should be its task to depict the drugs widely used by the population and to present them correctly and comprehensibly. This study analyzes 71 articles from 2012 to 2022 in terms of form, content, and comprehensibility. The analysis shows that in DIE ZEIT, drug groups largely correspond to the prescription figures and disease prevalence in Germany, with cardiovascular, neuropsychiatric, and pain medications being frequently discussed. There are deviations in the case of oncological drugs, for example, which are discussed more frequently than prescribed. New drug approvals are reported less frequently, and when they are, it is usually about the research phase. DIE ZEIT often reports on findings that are less than a week old and frequently quotes trustworthy experts, but no scientific sources can be found in around a quarter of the articles. A COVID-19 effect can also be identified in the years 2020 to 2022, as reporting on drugs for the treatment of coronavirus disease 2019 (COVID-19) predominated. An important point of criticism was identified with regard to comprehensibility. Less than half of the articles achieved the cut-off value for general comprehensibility specified by the Textlab analysis program, and only one article achieved the value for target group-oriented comprehensibility. This analysis confirms the problem that science communication is often too complicated and incomprehensible. It discusses the tension between the prescribed drugs and the mission of DIE ZEIT to entertain and should serve as a basis for analyzing other newspapers. Finally, we make specific suggestions how presentation of pharmacological topics in lay media can be improved in the future.

Prescriptions of homeopathic remedies at the expense of the German statutory health insurance from 1985 to 2021: scientific, legal and pharmacoeconomic analysis.

The prescription of homeopathic remedies at the expense of the statutory health insurance (SHI) system in Germany has been criticized for years due to a lack of evidence. Now, on the planned abolition of the reimbursement of homeopathic medicines in Germany, the debate on this topic has been reignited. The aim of this paper is to show the costs and their development over time incurred by homeopathic remedies in the healthcare system from 1985 to 2021. For this purpose, 15 selected homeopathic medicines were chosen from the drug prescription report (Arzneiverordnungsreport) and analyzed with regard to their development of DDD (Defined Daily Dose) using data from the Wissenschaftliches Institut der Ortskrankenkassen (WidO, Scientific Institute of the General Local Health Insurance Funds) and compared with their respective rational pharmacological alternatives. The price comparison was based on the DDD costs and the pharmacy retail price of the smallest packaging in each case. The clinical study situation for the preparations was also analyzed. For this purpose, the clinical studies provided by the manufacturer and those on PubMed were divided into evidence levels and analyzed. In addition, the presentation of homeopathic remedies on company websites, in online pharmacies, in specialist information and package leaflets was analyzed with regard to side effects, interactions, indication, and information on the alleged effect/proof of efficacy. In many media, information on homeopathic medicines remained incomplete, and non-compliance with the Therapeutic Product Advertising Act (Heilmittelwerbegesetz) was noted. Naming of the products if often very suggestive, too. Manufacturers' claims of efficacy go far beyond what can be considered proven in terms of evidence-based medicine and the quality of most clinical studies is poor. Homeopathic remedies are on average significantly more expensive than their rational pharmacological alternatives. Furthermore, DDD costs have continued to rise over the years analyzed. In aggregate, from a pharmacoeconomic, legal, and scientific perspective, abolition of reimbursement of homeopathic medicines in Germany at the expense of the SHI system is well justified.

Drug advertising in the German free-of-charge health magazine Apotheken Umschau (Pharmacy review): a critical analysis.

In Germany, the Apotheken Umschau (Pharmacy review) is a very popular health magazine for lay people, which is available free of charge in pharmacies. In this study, drug advertising in the Apotheken Umschau was critically analyzed. To our knowledge, studies on drug advertisements in such magazines are scarce. For the analyses, a total of 123 different advertisements from all 48 issues of Apotheken Umschau in 2020 and 2021 were compared. Since 2021 is the first year that was completely characterized by the COVID-19 pandemic, it was thus also possible to work out pandemic effects. More preparations from the categories immune system, eyes and sleep were advertised in 2021. Accordingly, typical complaints home office workers were addressed. Advertisements provided only very modest scientific information, if at all. The Therapeutic Products Advertising Act (Medicines Advertising Law; Heilmittelwerbegesetz (HWG)) provides regulations regarding the handling of drug advertising. However, in various categories, we noted substantial deficiencies of the advertisements to comply to regulations, e.g. the disclosure of adverse effects and omission of the mandatory statement "For risks and adverse effects, read the package insert and ask your doctor or pharmacist (Für Risiken und Nebenwirkungen fragen Sie Ihren Arzt oder Apotheker oder lesen Sie die Packungsbeilage)". Fifty-one of the 123 advertisements featured females to appeal particularly to this target group. Furthermore, a homogeneous ethnic (Caucasian) picture and a traditional image of German society were presented although this clearly deviates from reality. In conclusion, this study provides insights into the yet poorly studied mechanisms of drug advertisement for lay people. Pharmacological evidence plays a much smaller role than psychology, marketing and traditional societal models. It appears that drug companies intentionally use the "grey area" of the Medicines Advertising Law to optimally promote their products and ignore mandatory statements. This practice must be stopped by stricter legal control to protect the consumer from misinformation. In this way, drug safety will be increased.

How do German pharmacologists publish in the non-peer-reviewed science magazine Biospektrum?

Publications in peer-reviewed journals are the most important currency in science. But what about publications in non-peer-reviewed magazines? The objective of this study was to analyze the publications of scientists, with a focus on pharmacologists, in the non-peer-reviewed German science magazine Biospektrum from 1999 to 2021. Biospektrum is edited by five scientific societies in Germany including the Society for Experimental and Clinical Society Pharmacology and Toxicology (DGPT) and provides opportunities to researchers to showcase their research to a broad audience. We analyzed 3197 authors of 1326 articles. Compared to the fields of biochemistry, microbiology, and genetics, pharmacology was largely underrepresented. Just three institutions in Germany contributed most papers to Biospektrum. Researchers with a doctoral degree were the largest author group, followed by researchers with a habilitation degree. Among all major fields, women were underrepresented as authors, particularly as senior authors. The Covid pandemic leads to a drop of publications of female first authors but not last authors. Compared to publications in the peer-reviewed journal Naunyn-Schmiedeberg's Archives of Pharmacology (Zehetbauer et al., Naunyn-Schmiedebergs Arch Pharmacol 395:39-50 (2022)), female pharmacologists were underrepresented in the Biospektrum. Thus, German pharmacologists as a group do not value investing in "social impact" gained by publications in Biospektrum, and this attitude is even more prominent among female pharmacologists. Investing less in "social impact" by female pharmacologists may result in reduced visibility on the academic job market and may contribute to reduced opportunities to achieve high academic positions.

Critical analysis of ginkgo preparations: comparison of approved drugs and dietary supplements marketed in Germany.

Demographic change is taking place in the population of western industrialized countries, and the population is aging constantly. As a result, the mortality rate of patients due to dementia is rising steadily. To counteract this, the relevance of neuroprotective agents is increasing. Preparations from the medicinal tree species Ginkgo biloba ("gingko") are becoming increasingly popular. In this study, 63 ginkgo preparations marketed in Germany were analyzed. The following data were collected from the package inserts of the preparations: Country of manufacture, approval as a drug, compliance to target values of flavone glycosides, compliance to target values of terpene lactones, compliance to target values of ginkgolic acids, dosage per unit in milligrams (mg), duration of use, interactions with other drugs, contraindications, adverse effects and daily defined dose costs. In the next step, these data were compared in the following form: Total preparations versus preparations with drug approval versus dietary supplements. Almost without exception, the results indicate a pharmaceutical reliability of the preparations with drug approval and a dubious reliability of the preparations marketed as dietary supplements. Thus, ginkgo preparations marketed as dietary supplements appear to have an economic rather than a medical focus. We discuss the evidence of efficacy, and other criteria mentioned above, to evaluate the adequacy of the costs for the statutory health insurance that pay for preparations with drug approval in Germany. From the analysis of our results it is very doubtful that ginkgo biloba extract preparations of the food industry have any health benefit. It must be evaluated whether prohibition of selling ginkgo biloba extract as a dietary supplement is an option.

Fake paper identification in the pool of withdrawn and rejected manuscripts submitted to Naunyn-Schmiedeberg's Archives of Pharmacology.

Honesty of publications is fundamental in science. Unfortunately, science has an increasing fake paper problem with multiple cases having surfaced in recent years, even in renowned journals. There are companies, the so-called paper mills, which professionally fake research data and papers. However, there is no easy way to systematically identify these papers. Here, we show that scanning for exchanged authors in resubmissions is a simple approach to detect potential fake papers. We investigated 2056 withdrawn or rejected submissions to Naunyn-Schmiedeberg's Archives of Pharmacology (NSAP), 952 of which were subsequently published in other journals. In six cases, the stated authors of the final publications differed by more than two thirds from those named in the submission to NSAP. In four cases, they differed completely. Our results reveal that paper mills take advantage of the fact that journals are unaware of submissions to other journals. Consequently, papers can be submitted multiple times (even simultaneously), and authors can be replaced if they withdraw from their purchased authorship. We suggest that publishers collaborate with each other by sharing titles, authors, and abstracts of their submissions. Doing so would allow the detection of suspicious changes in the authorship of submitted and already published papers. Independently of such collaboration across publishers, every scientific journal can make an important contribution to the integrity of the scientific record by analyzing its own pool of withdrawn and rejected papers versus published papers according to the simple algorithm proposed in the present paper.

The Concise Guide to PHARMACOLOGY 2023/24: Enzymes.

The Concise Guide to PHARMACOLOGY 2023/24 is the sixth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of approximately 1800 drug targets, and about 6000 interactions with about 3900 ligands. There is an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes almost 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point-in-time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/10.1111/bph.16176. In addition to this overview, in which are identified 'Other protein targets' which fall outside of the subsequent categorisation, there are six areas of focus: G protein-coupled receptors, ion channels, nuclear hormone receptors, catalytic receptors, enzymes and transporters. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid-2023, and supersedes data presented in the 2021/22, 2019/20, 2017/18, 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature and Standards Committee of the International Union of Basic and Clinical Pharmacology (NC-IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate.

Presentation of the obsolete drug reserpine in three German-language pharmacology textbooks.

For several decades, reserpine was used to treat hypertension and, to a limited extent, psychoses. Over time, however, the indication became more and more restricted to the point of obsolescence. This study examines the extent to which textbooks are up to date in their content and oriented towards therapeutic guidelines, using the obsolete drug reserpine as a paradigm. Three German pharmacology textbook series were examined for the coverage of reserpine from 1964-2023: Allgemeine und Spezielle Pharmakologie und Toxikologie (Aktories), Allgemeine und Spezielle Pharmakologie und Toxikologie (Karow) and Pharmakologie und Toxikologie (Lüllmann). We compared the textbook content with data on reserpine prescriptions and hypertension guidelines and analysed the relevance of reserpine in examinations using German federal exam questions by the Institute for medical and pharmaceutical exam questions (IMPP). The textbooks differ conceptually from each other. The indication of reserpine for hypertension has become more restricted over time in all three textbooks, yet they partially show discrepancies with hypertension guidelines. The reserpine prescription figures show a strong decline , and reserpine has not been queried by the IMPP, which underlines the obsolescence of the drug. Overall, our study shows that the presentation of a representative obsolete drug in pharmacology textbooks lags current medical practice. We also unmasked more differences in the presentation of an obsolete drug in standard textbooks than anticipated. In conclusion, the analysis of obsolete drugs in pharmacology textbooks is an informative way of assessing how up-to-date they are.

Clinical trials on curcumin in relation to its bioavailability and effect on malignant diseases: critical analysis.

Curcumin is an ingredient of the root Curcuma longa, which is responsible for the characteristic yellow color of curcuma. Curcumin is said to have the potential ability to fight malignant diseases and to have an anti-inflammatory effect. In addition, it is used as a dietary supplement. However, one problem with the use of curcumin is its extremely low bioavailability. The aim of this study is to systematically review and critically analyze clinical studies related to the pharmacokinetics (or bioavailability) and to the use of curcumin in the treatment of malignant diseases. The platforms clinicaltrials.gov and PubMed served as the database for the literature research. A total of 293 available studies on curcumin were filtered according to their focus (bioavailability, therapy of malignant diseases) and other criteria (study results, main substance, topic reference, existing disease/other research purpose, reference to malignant diseases). The studies were further analyzed regarding their outcome measures, their design (number of participants, randomization, placebo group, masking, ethical standards, sponsor, primary outcome measures, secondary outcome measures, study bias) and their findings. The analysis failed to convincingly demonstrate that curcumin has a significant, positive effect on the therapy of malignant diseases. Regarding the increase in bioavailability, positive results have been obtained, which are in proximity to the pharmaceutical industry. Independent studies could not achieve increased bioavailability of curcumin. The available reviews in the literature also do not provide convincing evidence for the efficacy of curcumin. Thus, at the time being, the use of curcumin in malignant diseases is not justified scientifically.

Metadata analysis of retracted fake papers in Naunyn-Schmiedeberg's Archives of Pharmacology.

An increasing fake paper problem is a cause for concern in the scientific community. These papers look scientific but contain manipulated data or are completely fictitious. So-called paper mills produce fake papers on a large scale and publish them in the name of people who buy authorship. The aim of this study was to learn more about the characteristics of fake papers at the metadata level. We also investigated whether some of these characteristics could be used to detect fake papers. For that purpose, we examined metadata of 12 fake papers that were retracted by Naunyn-Schmiedeberg's Archives of Pharmacology (NSAP) in recent years. We also compared many of these metadata with those of a reference group of 733 articles published by NSAP. It turned out that in many characteristics the fake papers we examined did not differ substantially from the other articles. It was only noticeable that the fake papers came almost exclusively from a certain country, used non-institutional email addresses more often than average, and referenced dubious literature significantly more often. However, these three features are only of limited use in identifying fake papers. We were also able to show that fake papers not only contaminate the scientific record while they are unidentified but also continue to do so even after retraction. Our results indicate that fake papers are well made and resemble honest papers even at the metadata level. Because they contaminate the scientific record in the long term and this cannot be fully contained even by their retraction, it is particularly important to identify them before publication. Further research on the topic of fake papers is therefore urgently needed.

Repurposing of H1-receptor antagonists (levo)cetirizine, (des)loratadine, and fexofenadine as a case study for systematic analysis of trials on clinicaltrials.gov using semi-automated processes with custom-coded software.

To gain a comprehensive overview of the landscape of clinical trials for the H1-receptor antagonists (H1R antagonists) cetirizine, levocetirizine, loratadine, desloratadine, and fexofenadine and their potential use cases in drug repurposing (the use of well-known drugs outside the scope of the original medical indication), we analyzed trials from clincialtrials.gov using novel custom-coded software, which itself is also a key emphasis of this paper. To automate data acquisition from clincialtrials.gov via its API, data processing, and storage, we created custom software by leveraging a variety of open-source tools. Data were stored in a relational database and annotated facilitating a specially adapted web application. Through the data analysis, we identified use cases for repurposing and reviewed backgrounds and results in the scientific literature. Even though we found very few trials with published results for repurpose indications, extended literature research revealed some prominent use cases: Cetirizine seems promising in mitigating infusion-associated reactions and is also more effective than placebo in the treatment of androgenetic alopecia. Loratadine may be beneficial in the prophylaxis of G-CSF-related bone pain. In COVID-19, H1R antagonists may be helpful, but placebo-controlled scientific evidence is needed. For asthma, the effect of H1R antagonists only seems to be secondary by alleviating allergy symptoms. Our novel method to find potential use cases for repurposing of H1R antagonists allows for high automation, reduces human error, and was successful in revealing potential areas of interest. The software could be used for similar research questions and analyses in the future.

Histamine H1- and H4-receptor expression in human colon-derived cell lines.

In previous studies, we demonstrated the involvement of H4R in inflammatory bowel disease (IBD) and IBD-associated colon cancer in mice and could ascribe H4R-mediated histamine function to colon epithelial cells. The transferability of obtained data to humans is however lacking. Functional expression of H4R on colon epithelial cells is a prerequisite to pursue the hypothesis of involvement of H4R in carcinogenesis. Thus, we here compared the expression of histamine receptor subtypes in a series of cell lines. Out of these, three colon-derived cell lines displaying different combinations of H1R and H4R expression were submitted to functional analyses. Human hematopoietic HMC-1, HL-60, and U937, lung-derived A549 and Calu-3, and colorectal LoVo, SW 480, Caco-2, HT-29, and HCT116 cells were included in the study. mRNA expression was quantified by RT-qPCR. For functional analyses, Caco-2, HT-29, and HCT116 cells were treated by incubation with 1 - 10 µM histamine in the presence or absence of selective histamine receptor antagonists. Calcium mobilization, cAMP accumulation, and cell proliferation were measured by fluorimetry, mass spectrometry, and real-time bioimpedance measurements, respectively. Histamine receptor expression was heterogeneous in the cell lines tested. In most cell lines, we detected H1R mRNA while H4R mRNAs were found only occasionally. The colon-derived epithelial cell lines LoVo, SW480, and HT-29 expressed H1R mRNA exclusively, while in HCT116 cells H1R and H4R mRNAs and in CaCo-2 H2R mRNA were detectable. Subsequent functional analyses in HT29, Caco-2, and HCT116 cells, however, indicated that only HT-29 responded to histamine stimulation, by means of H1R. For a detailed analysis of histamine receptor function, esp. that of H1R and H4R, in human colon-derived cell lines, the cell lines tested here are not fully convenient unless genetically modified.

cCMP and cUMP phosphodiesterases in viral infections.

In bacteria, cCMP and cUMP have a key role in defense against infection with bacterial viruses. Bacteriophages encode phosphodiesterases (PDEs; 'nucleases'; Apyc1), which cleave cCMP/cUMP, counteracting this defense. We propose that PDEs are of broader biological relevance, including cCMP/cUMP-cleaving PDEs of eukaryotic viruses, which may constitute new drug targets.

Critical analysis of the prescription and evaluation of protein kinase inhibitors for oncology in Germany.

The prices of oncology drugs have been rising progressively in recent years. Despite accounting for only a small share of prescriptions, oncology drugs are the most expensive drugs on the market. However, the association between drug price and clinical benefit often remains questionable. Therefore, we set out to analyze the development of prescription and benefit assessment of protein kinase inhibitors. We identified 20 protein kinase inhibitors with oncological indications that were newly approved by the European Medicines Agency (EMA) between 2015 and 2019, based on the Arzneiverordnungsreport (AVR, Drug Prescription Report). For these 20 drugs, the number of prescriptions, sales, defined daily dose (DDD), and DDD costs were identified for the year of approval and for 2020, respectively, based on data from the Wissenschaftliches Institut der Ortskrankenkassen (WIdO, Scientific Institute of the General Local Health Insurance Fund, AOK). Moreover, the additional benefit assessments by the Gemeinsamer Bundesausschuss (GBA, Federal Joint Committee) were considered for each drug. It is shown that the share of a drug in prescriptions, sales, and DDD does not correlate with the clinical benefit of the drug as measured by the additional benefit assessment by the GBA. Lastly, the advertisement pattern of protein kinase inhibitors in a representative oncology journal does not correlate with drug benefit. In conclusion, the immense costs of oncology drugs are therefore largely caused by drugs for which no additional benefit has been proven by the GBA. In order to ensure the long-term stability of health care systems, price-regulation measures are urgently needed, especially for drugs whose additional benefit has not been proven.