In a clear statement on the absurdity of public funding and regulation of homeopathy, British MPs instructed government to stop paying for homeopathy, shut down homeopathic hospitals, cease all homeopathy clinical trials, and to crack down on homeopathic efficacy claims.
Committee chairman Phil Willis MP said; “We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not.”
Homeopathy doesn’t work. It can’t work. If it did, physics, biochemistry and pharmacology as pharmacists know it would be false. Yet this elaborate placebo system persists, supported in part by the pharmacy profession, which seems comfortable selling products with no active ingredients and no evidence of efficacy.
I have blogged previously about the British inquiry into homeopathy, the public relations disaster for Boots the Chemist (selling their own store brand of homeopathy), and the effectiveness of the “10-23” protesters, who staged a mass homeopathic overdose, where, not surprisingly, nothing untoward happened to anyone.
The final report from the British inquiry has been released. It scrutinized government policies on homeopathy, and gives direction to the National Health Service. But the recommendations apply to any country (like Canada) that legitimizes homeopathy.
In a report published today, the Science and Technology Committee concludes that the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.
The Committee carried out an evidence check to test if the Government’s policies on homeopathy were based on sound evidence. The Committee found a mismatch between the evidence and policy. While the Government acknowledges there is no evidence that homeopathy works beyond the placebo effect (where a patient gets better because of their belief in the treatment), it does not intend to change or review its policies on NHS funding of homeopathy.
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.
The Committee concluded—given that the existing scientific literature showed no good evidence of efficacy—that further clinical trials of homeopathy could not be justified.
In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice—which the Government claims is very important—as it means patients do not have all the information needed to make choice meaningful.
Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.
The report also examines the MHRA licensing regime for homeopathic products. The Committee is particularly concerned over the introduction of the National Rules Scheme (NRS) in 2006, as it allows medical indications on the basis of study reports, literature and homeopathic provings and not on the basis of randomised controlled trials (RCTs) – the normal requirement for medicines that make medical claims.
The MHRA’s user-testing of the label for Arnica Montana 30C—the only product currently licensed under the NRS—was poorly designed, with some parts of the test little more than a superficial comprehension test of the label and other parts actively misleading participants to believe that the product contains an active ingredient.
The product labelling for homeopathic products under all current licensing schemes fails to inform the public that homeopathic products are sugar pills containing no active ingredients. The licensing regimes and deficient labelling lend a spurious medical legitimacy to homeopathic products.
The last sentence can equally be applied to Health Canada and its Natural Health Products Directorate, which also endeavors to assign unique numbers to indistinguishable bottles of sugar pills.
The major recommendation related to the sale of homeopathy is as follows, and relates to the implied endorsement (through licensure) of homeopathic products by the MHRA, which is the UK equivalent to Health Canada or the FDA:
We consider that the way to deal with the sale of homeopathic products 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.
Anthony Cox, an English pharmacist who blogs at the excellent Black Triangle blog has the following analysis:
The committee stops short of suggesting homeopathy should not be sold by pharmacies, instead preferring that they are sold honestly. The central problem with homeopathy is the legitimacy given to it by NHS funding and government regulation. Tackling that will improve the position pharmacists are put in.
However, there is still plenty of work to be done in pharmacy. How can it be that there is a registered pharmacy regulated by the Royal Pharmaceutical Society supplying Leptospira, leprosy, and hepatitis remedies openly over the internet? It’s hard to reconcile that pharmacy’s continued registration with the Society’s position on homeopathy.
It’s time to begin the discussion in Canada. Why does Health Canada states that their approval of a homeopathic product means that it is safe, effective, and of high quality, when it’s clear that homeopathy is a placebo, and has no active ingredients? Why does Health Canada allow anecdotal evidence as evidence of efficacy statements for these products? Why are Canadian pharmacies told that the sale of homeopathy is acceptable, when Health Canada has given its stamp of approval? And why are Ontario, British Columbia, and other provinces endorsing and expanding the roles for alternative health practitioners, that are trained and “qualified” in homeopathic pseudoscience?
More coverage here:
Black Triangle: Homeopathy and Pharmacy
Ben Goldacre: Parliamentary Sci Tech Committee on Homeopathy
Podblack Cat: Recommendation – Homeopathy Gone From The NHS!
The Quackometer: The Bleakest Day for Homeopathy
Australian Skeptics: UK Government committee recommends public funds pulled from homeopathy