Final answer:
Drugs may show more toxicities in the general public after FDA approval due to the larger variety of patients with different conditions and medications, which can lead to rare side effects. Continuous pharmacovigilance is necessary to monitor and evaluate these long-term effects and interactions that may not have been evident during controlled clinical trials.
Step-by-step explanation:
The reason why drugs that made it past phase 3 and received FDA approval may show more toxicities when made available to the general public is due to the expansion of the patient pool once a drug hits the market. While clinical trials involve a controlled, limited number of participants, the post-marketing phase involves a much larger and more diverse population. This can include people with different demographics, comorbid conditions, and concomitant medications, which may lead to the identification of rare side effects or interactions not seen in clinical trials.
In the pre-approval phases, safety and efficacy are evaluated under controlled environments. However, after approval, pharmacovigilance systems are crucial for continuing evaluation of long-term safety and specific subgroup effects. Therefore, the increase in reported toxicities in the public may also reflect the comprehensive nature of post-market surveillance, which is designed to protect public health.