Table 2.

Post-marketing withdrawal of medicinal products because of adverse drug reactions in different continents

Continent	No. of countries	Total population (millions)	No. of withdrawn products	Rate of withdrawals/million population	Rates of withdrawal/country	RR of withdrawal per country versus Africa (95 % CI)a	a P value versus Africa
Africa	54	1111	63	0.06	1.17	–	–
Asia	46	4427	150	0.03	3.26	1.42 (1.18–1.71)	0.001
Australasia & Oceania	11	30	32	1.07	2.91	1.38 (1.08–1.76)	0.045
Europe	50	742.5	309	0.42	6.18	1.60 (1.34–1.90)	<0.0005
N. America	23	528.7	134	0.25	5.83	1.59 ( 1.32–1.90)	<0.0005
S. America	12	387.5	65	0.17	5.42	1.57 (1.29–1.90)	<0.0005

^aThe P values have been corrected for multiple tests using the Bonferroni method. The relative rates of withdrawal are calculated based on the assumption that if a medicinal product was withdrawn in one country, it should also have been withdrawn in all countries in that continent. The data for total populations are obtained from the 2013 World Population Data Sheet (http://www.prb.org/pdf13/2013-WPDS-infographic_MED.pdf). This analysis excludes 43 medicinal products withdrawn worldwide