Because so much of 20th-century drug research happened in the US (because the US had capitalism) the clinical-trials requirement and the Drug War there had an outsized effect, and other countries copied them afterwards.
One particular case that I studied was Zasloff's "magainin": https://en.wikipedia.org/wiki/Magainin which was denied licensing even though the clinical trials found that it was both safe and effective. The problem was that it wasn't more effective than the existing standard of care; it was only equally effective.
It seems certain that the Kefauver–Harris Drug Act has prevented innumerable cases of useless or harmful drugs from being marketed. But, looking at the history of drug development, it also seems clear that the rapid drug development in the decades up to 01962 virtually halted at that time, and the absence of the drugs that would have been discovered since then has surely killed many more people than the inadvertent use of harmful drugs ever could have.