Today England’s Science and Technology Committee published it’s “Evidence Check 2″ report on Homeopathy.
Overall, it’s a resounding “no” to homeopathy. The report comes down hard on UK government agencies relationships to homeopathy and recommends stronger transparency in the commercial sector, too.
The report was to look at government policy, particularly the NHS (England’s National Health System) funding and provision of homeopathy and on MHRA licensing of these remedies. (MHRA = Medicines and Healthcare products Regulatory Agency.)
Given the amount of material reviewed, it’s a reasonably compact report, with pages 1-47 covering all most people will want to read.
I’m going to leave aside the science arguments for later articles and deal with only their overall conclusions and their remarks about pharmacies here. I’m condensing, so visit the full documents if you want the original contexts.
Among the recommendations (p43-47) are:
On homeopathy, that:
Homeopathy is not efficacious, i.e., homeopathy does not work beyond the placebo effect
On research, that:
Further clinical trials of homeopathy are not justified because the existing scientific literature shows no good evidence of efficacy
On homeopathy advocates’ “evidence”, they slap some faces:
“We regret that advocates of homeopathy, including in their submissions to our inquiry, choose to rely on, and promulgate, selective approaches to the treatment of the evidence base as this risks confusing or misleading the public, the media and policy-makers.”
On the NHS (National Health System):
The NHS (National Health System) should stop funding homeopathy and homeopathic hospitals. (The Scotsman claims there are four homeopathic hospitals run by the NHS.)
The government should disclose the total amount spent on homeopathy via the NHS. (No prizes for prizes for guessing that some politicians are not going to like this!)
They express concern over prescribing placebos. There’s a bit to this, being something of a moral argument. They note that prescribing placebos conflicts with a patient’s right to an informed choice, if it involves deceit involves disclosing that it’s a placebo if doctors are to avoid the deceit. They note that by offering homeopathy, the NHS is effectively endorsing it. (In a similar way, I don’t think pharmacies should be offering it either.)
On the licensing of homeopathic remedies:
That homeopathic remedies should not allowed to duck evidence of efficacy to obtain licenses. (This is similar in vein to my thoughts that the onus on proof of efficacy is on those producing and selling remedies.)
Homeopathic products should no longer be licensed by the MHRA, because homeopathic remedies are not medicines.
They expressed concern that the National Rules Scheme (NRS) allows that product be indicated to be used as a medicine based on informal studies, not randomised controlled trials (RCTs).
They note that the label of the only product licensed under the NRS in part misleads participants “to believe that the product contains an active ingredient”, similar to sentiments that I expressed concern over in an earlier article.
They dismiss pharmacies view they should be allowed to provide these remedies on the basis of consumer demand, pointing out that pharmacists are obligated to inform the consumer that the product will not work beyond a placebo effect and that they are required to:
ensure that patients with symptoms that may require further medical investigation and treatment are not led to believe that a homeopathic remedy is effective beyond the placebo effect.
They, however, conclude that banning the products from pharmacies is inappropriate given that the products can be obtained over the internet (poor logic, to my mind: that they are available elsewhere is quite besides the point) and that they sell other non-evidence based remedies (poor logic: that other related things are “wrong” doesn’t make the thing under question “right” or acceptable).
Leaving aside the reasoning for their suggested approach, what they suggest as the appropriate approach is to:
remove any medical claim and any implied endorsement of efficacy by the MHRA–other than where its evidential standards used to assess conventional medicines have been met–and for the labelling to make it explicit that there is no scientific evidence that homeopathic products work beyond the placebo effect.
I like that they recommend an disclaimer pointing out the lack of evidence for efficacy, which I’ve previously suggested. (Perhaps pointing out the lack of active ingredients might also be a useful addition to the disclaimer.)
They express concern over the time taken to address claims of breaches of pharmacies’ working guidelines, presumably “pushing” the product too hard or giving poor advice, such as recommending the product for something it cannot achieve.
So what does all this mean for New Zealand? Share your thoughts.
I would present my thoughts here, but in order to be brief: I hope it indicates that a stronger line should be taken here. We ought to exploit that the UK has spent the time (and tax payer dollars euros pounds) on this exercise and take what we can benefit from it.
Update: Readers may wish to read Darcy Cowan’s thoughts on how selling homeopathic remedies in pharmacies in New Zealand relates to the Pharmacy Council Code of Ethics for pharmacists.
Other articles on homeopathy and other “alternative remedies” on Code for life:
Popularity does not mean effectiveness or sensibility (not really about homeopathy, but a wider point that is relevant for many things)