Jul 21 2017

Homeopathy Takes a Hit in the UK and Australia

dilutionI have long considered homeopathy to be the softest of targets for skeptics, especially in the area of alternative medicine. Homeopathy is 100% pure nonsense. It is a pre-scientific magical form of medicine that has no legitimate place in the modern world.

Further, homeopathy is particularly vulnerable because most people do not know how silly it is. They think it is natural or herbal medicine, but it’s not. Homeopathy involves taking fanciful treatments and then diluting them out of existence, based on the notion that the essence of the substance will be left behind and magically cure whatever ails you.

This means that simply educating the public about what homeopathy actually is can be an effective way to reduce its popularity. Knowledge is not sufficient, however, because there is no limit to what people are capable of believing. Nonsense is rarely eradicated entirely, but we can certainly restrict it to the fringe where it belongs.

Homeopathy in Australia

In 2015 the Australian National Health and Medical Research Council (NHMRC) concluding that homeopathic treatments were worthless, and that the scientific evidence has not shown that they work for any single indication.

Building on this finding, the Royal Australian College of General Practitioners advised doctors not to prescribe homeopathy, and also advised pharmacies not to stock homeopathic products. Dr. Jones, speaking for the Colleges, said:

“Given this lack of evidence, it does not make sense for homeopathy products to be prescribed by GPs or sold, recommended or supported by pharmacists.”

Just last month an independent review of pharmacy practice, the Review of Pharmacy Remuneration and Regulation, recommended that pharmacies no longer stock homeopathic products. They conclude:

The general consensus as demonstrated by submissions to the Review and the Panel’s face-to-face consultations is that homeopathy and homeopathic products do not belong in community pharmacies. The majority of pharmacists and other stakeholders argued that these products lack any evidence base and have sufficient evidence of non-efficacy to preclude their ethical sale in community pharmacies.

I am glade they used the work “ethical” – because the science is so conclusive that homeopathy is utterly worthless that presenting it in any way as if it is real medicine is an unethical disservice to the public.

Homeopathy in the UK

The UK has a national health service (NHS) that is a single government-paid health plan. You can still pay for health products and services privately, but all standard care is covered for all citizens. This means that government decisions about what medicines they will pay for have a dramatic effect on their availability.

Recently the NHS has been reviewing prescriptions that they cover, trying to weed out products that lack evidence for effectiveness or for which there are simply better options, or that can and should be available privately over the counter, but not through the NHS.

In March there were reports that homeopathy was apparently going to escape this “ban” on worthless treatments, although I couldn’t find out exactly why this was. Just today, however, there are reports that the NHS will bad the prescription of homeopathy. This is apparently fruit of a 2010 review by the UK House of Commons which concluded that homeopathy was “witchcraft.”

It cites a 2010 report by the House of Commons Science and Technology Committee which “found that the use of homeopathy was not evidence based and any benefits to patients was down to placebo effect”.

The NHS spends an estimated 4-5 million pounds on homeopathy per year, about 100,000 pounds of which is for prescriptions. This has been steadily decreasing in the last 20 years. In 1997 the NHS spent > 900,000 pounds on homeopathic prescriptions, down now by 90%.

Still, it would be nice to get rid of the last vestiges of homeopathy within the NHS.

Conclusion

It is one thing to argue that the public should have access to the products of their choice, even if they are not science-based. I disagree with this in practice, because I think there is always deception involved. Even selling such products in a pharmacy is an implied endorsement of legitimacy.

You could make a case for selling products like homeopathy if they were explicitly and clearly labeled, so that there was no question what you were buying. This would involve statements such as – this is not medicine, there is no evidence it is effective, contains no active ingredient, etc. It would also involve making no health claims. In the end, of course, you would have a virtually unsellable product, and that is the point. In order to sell homeopathy you have to deceive.

In any case, even if you think people have the right to make horrible choices like purchasing sugar pills thinking they are magic, this does not lead to the conclusion that anyone should be forced to pay for such nonsense – which means governments should not pay, nor should insurance companies or health plans be forced to cover them.

In the US, which mainly has a private health care system (Medicare, Medicaid, and the VA system being exceptions) the big issue is about market regulation. Homeopathic products have a special designation within FDA regulation. They are treated as drugs, but they are automatically approved. They only have to be listed in the homeopathic pharmacopeia. This can be changed with an act of congress.

But actually an act of congress is not needed, because the FDA has the power to decide how to enforce the regulation of homeopathy, since they are technically drugs. The FDA simply chose to punt to the homeopathy industry. They could, without congress, decide to require evidence of efficacy for homeopathic products. That simple decision would instantly destroy homeopathic products in the US (not necessarily practicing homeopathic medicine).

The FDA is currently reviewing their regulation of homeopathy. We are anxiously waiting for their decision, which I suspect is on hold until the dust settles on the recent transition of power.

 

 

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