Homeopathy check-up: Not in the health system, disclaimers on labels

By Grant Jacobs 23/02/2010 26


Today England’s Science and Technology Committee published it’s “Evidence Check 2” report on Homeopathy.

evidence-check-2-homeopathyOverall, 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.”

Hampton House, the former site of Bristol Homeopathic Hospital, one of a handful of homeopathic hospitals run by the NHS. (Image & legend source: wikipedia.)
Hampton House, the former site of Bristol Homeopathic Hospital, one of a handful of homeopathic hospitals run by the NHS. (Image & legend source: wikipedia.)

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.

On pharmacies:

(Source: wikipedia)
(Source: wikipedia)

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)

Homeopathic remedies in NZ pharmacies

British homeopathy sceptics group aims for sugar high (with Dawkins video)

Ginkgo biloba does not stem loss of brain function in elderly

potpourri: homeopathy, journalism masterclasses & open access

The End of Chiropractic?


26 Responses to “Homeopathy check-up: Not in the health system, disclaimers on labels”

  • If that were the case then surely it’s the least efficacious and most expensive treatments that would be first on the chopping block – hardly an endorsement. And also, it was a parliamentary inquiry, not a government inquiry. Opposition politicians sit on parliamentary committees, and have no interest in making the government’s books look good.

  • I haven’t read the entire report through yet, I’ve been flicking back and forth between the report proper and the evidential memoranda contained at he the end, but I am impressed with a relative lack of political equivocation.

    Overall I agree that policy makers here should take advantage of the ground work represented by this report to guide our own approaches to the issue.

    Like you I didn’t entirely agree with the decision that pharmacies should continue to sell these so called remedies but the disclaimer labels are a reasonable compromise. The observation in the report that pharmacies advertise themselves as the “scientists in the high street” undermines arguments that they should provide unscientific products simply by virtue of the demand for them.

  • I think it’s a good effort too.

    I’m more bothered by the reasoning offered to not discontinue sales in pharmacies than the recommendation itself in some ways. (It is a rough spot in an otherwise good effort, but that happens.) There is some sense in tightening up the requirements until the pharmacies are pushed to “wake up” and realise that their professional obligations oblige them to take the non-remedies (not just homeopathic ones) off their shelves themselves.

  • I regard to Pharmacist’s professional obligations I finally got around to writing a post on our own Pharmacists Code of Ethics and how it should relate to sale of homeopathic remedies. Should turn up on Sciblogs shortly.

  • please recognise the human sacrifice done by homoeopaths during the last two centuries towards the suffering humanity. allopathy is more of a herd treatment and never intended to take care of sick individuals from a very personal level. homeopathy is aiming in delivering a more holistic and individualistic health solution. spending some money for individualistic understanding is no waste instead we all have to support homeopathy as a science and more inquiry into homeopathy from intellectual level is needing.bringing philosophers into the net to understand homoeopathy is a better way to understand the science behing homeopathy.

  • our homoepathic pharmaceutical manufacturers are more saner than allopathic money minded dumbing of medicines.homeopaths have been very harmless and sensible in using medicines. many a time we ourselves prepare medicines taking into considerating the hygenic and other factors into consideration.we don’t realise the pain taken by homeopaths in empathising with their patients. popularity in democracy means the effectivity and acceptabiltity. the patients are better judges,goverment need not support homoeopathy,it all requires acknowledgment of the democratitically elected goverment to understand the sentiments of sick and poor people all over the globe. who else can treat sick patients more economically than the homeopaths today. it needs courage and will to be a homoeopath to survive in this diverse society thinking.kindly support homeopathy for it has sacrificed more than enough to provide a holistic treatment to needy sick individuals.science and legal aspects apart,please recognise the concerns of homoeopaths and their patients who love to take homeo medicines especially children and elderly citizens.

  • Darcy,

    This fellow is Indian. I suspect he means the (metaphorical) sacrifice of homeopath’s time, etc., not sacrifice of patients, even though it is unintentionally rather funny!

  • Mr. Murugan,

    Allopathy is more of a herd treatment and never intended to take care of sick individuals from a very personal level.

    (For readers, allopathy simply means “conventional medicine”.)

    Not true, and a terrible sweeping generalisation.

    I suspect you are trying to set up an argument that homeopathy focuses on the individual and therefore it “must” be better.

    Firstly, dismissing “the other side” with sweeping generalisations doesn’t make arguments like that right.

    Secondly, and more to the point, while there may be some truth that doctors—but not necessarily nurses—don’t spend much time as they might with patients, if the extra time spent by homeopaths, naturopaths, etc., doesn’t yield a better outcome than conventional medicine, then the extra time is for no good end.

    What matters is the outcome. As the report points out, homeopathy only delivers up to the level of placebo. Conventional medicines have to provide evidence that they go beyond that.

    Popularity in democracy means the effectivity and acceptabiltity.

    See: http://sciblogs.co.nz/code-for-life/2010/01/26/popularity-does-not-mean-effectiveness-or-sensibility/

    the patients are better judges

    Common-sense suggests to me that interested parties are poor judges, whatever it is that they might be interested in: be it buying a computer, house, car or obtaining medical treatment. Humans are a rather wishful, emotion creatures… Doctors as a rule won’t deal with people they are too close to, as it can cloud their judgement. In a similar way, getting independent expert advice about just about anything that really matters is a sound idea! You get an independent building inspector for the house, a vehicle inspection for a car, etc…

    While some types of feedback have to be given by a patient, I think it’s fair to say that generally they are not good judges of the meaning of what their symptoms means.

    Likewise assessment of a trial of a treatment should be independent of all interested parties. (It’s why scientific trials and randomised and blinded.)

    kindly support homeopathy

    I will support what evidence shows deserves support. Seeing as evidence shows that homeopathy doesn’t deserve support, that’s where my support will go.

    (I refer to you as “Mr.” as, like Ms. Malik, I believe you do not have qualifications that entitle to use the title “Dr” in NZ and I would think most other countries. I personally prefer people to not use titles (Dr., Prof., etc.) and to call their career by the common name, e.g. biologist, homeopath, etc.)

  • It’s come to attention that others argue that the intentions in homeopathy’s founder (Hahnemann) use of the term ‘allopathy’ and what is meant by modern medicine differ. If so, my explanation of the meaning of the term is wrong. Interested readers may want to read Kimball Atwood’s explanation (see the section ‘Homeopathy vs. “Allopathy”’):

    http://www.sciencebasedmedicine.org/?p=21

    She writes that ‘allopathy’ was originally was meant as a reference to only suppressing symptoms, which is not what modern medicine aims to do. She goes on to explain how even in it’s own day, the use of the term didn’t make sense (some “conventional” treatments of the day were aimed at the underlying cause, even if the treatments would not be considered sound today).

    Kimball is pointing out a straw-man argument make by proponents of homeopathy, where through this term modern medicine is incorrectly represented as only dealing with symptoms and not the underlying causes.

  • MR MURUGAN,

    our homoepathic pharmaceutical manufacturers are more saner than allopathic money minded dumbing of medicines

    there is no evidence stating that , homeopathic medicines are more saner or allopathic medicines are more dumbing.
    kindly know what you are speaking.
    most homeopathic medicines are placebo acting
    homeopathy does not manage emergencies, surgeries, autoimmune. everything has its own limitations.
    there are no active researches that are being made in homeopathy to improve what was done centuries back.
    allopathy is updating itself but homeopathy is just based on what was told centuries back. it does not practise evidence based medicine.
    defenitely people are the judges and they will choose what they want.

  • @ Mr Murugan who said “our homoepathic pharmaceutical manufacturers are more saner than allopathic money minded dumbing of medicines”

    There is no DUMBING MONEY MINDED ALLOPATHIC MEDICINES that I have heard of.
    Besides life saving drugs like newer generation corticosteroids used in numerous autoimmune diseases costs less then 2 Rs. AntIbiotics like doxycycline costs 1.50 Rs, dapsone used in mutiple neutrophilic dermatoses is less than 2 Rs. Aspirin used as an emergency drug in MI is 1 Re.
    Besides many homepaths use a blanket term for ” adverse effects of homeopathic medications” by simply calling it as ” healing effect of the drug” which I totally disagree. Adverse effect is just adverse effect, not healing.
    If Homeopathy is the only Holistic branch of medicine, what does it do tumours, cancer chemotherapy, tuberculosis,leprosy,burns, and numerous conditions?the list of diseases not very well controlled bu homeopathy goes beyond thousand.
    One should clearly understand the limitations of homeopathy and guide the patients as to what would be the most beneficial therapy based on their ailments. Ultimately its upto them.
    Finally its for to guide the patients what is the best for their ailment and respect every branch of medicine accepting whatever flaws they hold.

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