Complementary Medicine & Pharmacists

I don’t know if the situation is the same in other countries, but in the Netherlands we can only get prescribed medications in pharmacies. Drugstores are only allowed to sell over-the counter (OTC) medicines.

Most Pharmacies have a small shop of 5 square meters (besides a large storage room). What surprises me is that the counter is not only full with non-allergic creams, and the shelves are not only filled with liquorice and plasters, but the counter and shelves predominantly display naturopathic and herbal “medicines”. In this flu-season there are even leaflets how to prevent flu with all kinds of naturopathic medicine. Dr Vogel’s Echinaforce “helps to augment your natural resistance, lowers the risk of flu and shortens the duration or decreases the severity of symptoms once you have the flu” (..”vermindert u de kans op griep en herstelt u sneller als u toch ziek wordt“). Apparently A Vogel.nl (via Biohorma) started a campaign in the Netherlands. At their website there is even an advertisement for an offer by an insurance company -OHRA- because it generously refunds homeopathic medicine. Biohorma also made a You-Tube video.
In contrast, in the US there is a disclaimer at the Echinaforce site:” These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease.”

There is no evidence that Echinacea prevents flu (see Cochrane Review and de Volkskrant [Dutch newspaper referring to clinical trials]), although it is not excluded that it helps for the early treatment of colds in adults.

Isn’t such a promotion of ineffective stuff a bad advice considering we have  a real flu-epidemic, and given the inverse relationship between pediatric vaccination and CAM usage (see Respectful Insolence)?

It is quite confusing, however, because Echinacea is advertised as an homeopathic medicine, whereas it seems a herbal medicine (not diluted ad infinitum). To date there is no evidence that homeopathy ‘works’. All 6 published Cochrane systematic reviews with ‘homeopathy’ or ‘homeopathic’ in the title conclude that there is little or no evidence that it works beyond the placebo-effect.

During the recent The House of Commons Science and Technology Committee meeting calling in homeopaths and scientists to discuss evidence for the alternative therapy Prof. Dr Ernst (with experience as a homeopath) said: “I have supplied a list of systematic reviews of homeopathy. There are two dozen. None in that list were positive.” (see this excellent summary of the meeting by Ian Sample). For the entire memorandum of Dr Ernst see here.

Besides that the clinical trials are ineffective, the whole theory is incompatible with the laws of physics and chemistry.

Nevertheless:

• There is a lot of homeopathic research going on, i.e. funded by the NHS (National Health Sevice) in the UK and the NCCAM (National Center for Complementary and Alternative Medicin, NIH) in the US.
• In the UK homeopathic medicine is endorsed by the MHRA (Medicines and Healthcare products Regulatory Agency)
• CAM is booming business (£1.5bn industry in the UK)
• CAM is covered by insurance companies.
• CAM is sold and sometimes advocated by pharmacists.

Thus all over the world people are buying these ineffective homeopathic medicines while believing they ‘work’, or at least cause no harm. However, while homeopathic medicines may not harm themselves, they may cause harm if they are used in place of proven treatment for any life-threatening illness.” Indeed the WHO has warned people with conditions such as HIV, TB and malaria not to rely on homeopathic treatments (BBC NEWS 20 August 2009 ) 

For me it is incomprehensible, that pharmacists who are trained in pharmacology and chemistry (at the University Level), just sell those ineffective costly water-dilutions and advocate them directly or indirectly by putting them on the shelves, providing ample leaflets and brochures and giving positive “advise”. What could be the reason for doing that other than ignorance or MONEY?

Recommended Reading:

• Pharmacy News (Australia):  Debate: do complementary medicines belong on pharmacy shelves? (12 Feb 2009)
• DC’s Improbable Science: Royal Pharmaceutical Society defends quackery (5 June 2008) UK
• DC’s Improbable Science: Can you trust Boots? (4 Nov 2007) UK
• Stephen Barrett, M.D.Varro E. Tyler. Ph.D. Homeowatch Why Pharmacists Should Not Sell Homeopathic Products
• Cochrane systematic review on Echinacea: CD000530
• The Guardian: Homeopathy: MPs on science and technology committee grill experts (Ian Sample 25 Nov 2009)
• Memorandum submitted by Edzard Ernst HO 16: http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm1602.htm
• Respectful insolence: CAM usage and vaccination status (22 Sep 2009)
• Downey, L., Tyree, P., Huebner, C., & Lafferty, W. (2009). Pediatric Vaccination and Vaccine-Preventable Disease Acquisition: Associations with Care by Complementary and Alternative Medicine Providers Maternal and Child Health Journal DOI: 10.1007/s10995-009-0519-5
• Respectful insolence:Homeopathy deconstructed in the FASEB Journal
• BBC News: Homeopathy not a cure, says WHO (20 Aug 2009)

Photo Credits

1. Pharmacists mortar and pestle http://commons.wikimedia.org/wiki/File:PharmacistsMortar.svg
2. Homeopathic Medicine on the shelves http://www.flickr.com/photos/caseywest/ / CC BY-SA 2.0
   (this photo has nothing to do with the subject)
3. DSC_3383: http://www.flickr.com/photos/hippie/ / CC BY-NC 2.0

, but all kind of complementary medicine (CAM).

Related articles by Zemanta

• Homeopathy: MPs on science and technology committee grill experts (guardian.co.uk)
• Homeopathy on the NHS is unethical, doctors tell MPs (guardian.co.uk)
• CAM usage and vaccination status (scienceblogs.com)
• Homeopathy deconstructed in the FASEB Journal (scienceblogs.com)
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