Pharmacists in the spotlight over CMs

It has been a tense time for those involved in complementary medicines, with pharmacists in the firing line.

First, Choice research found that in a ‘shadow shop’, almost one in three pharmacists recommended products that lack evidence to show they work.

Then an ABC Four Corners program investigated how complementary medicines (CMs) are regulated and marketed in Australia and whether the credibility of pharmacies is threatened by selling them.

The Choice shadow shop of 240 pharmacies, including Priceline, Chemist Warehouse and Terry White Chemmart, found many pharmacists are recommending alternative medicines that have little to no scientific evidence to prove their effectiveness.

“Our mystery shoppers were asked to approach the prescription-dispensing counter and ask for advice from the pharmacist about feeling stressed,” Choice Head of Media Tom Godfrey said.

“When a pharmacist was asked if there was something they could recommend for stress, worryingly, 26 per cent recommended products based on Bach-flower remedies and three per cent recommended homoeopathic products, for which there is no evidence of effectiveness.

“Products containing a B-group vitamin complex, for which there is some evidence it may help, were the most commonly recommended products [46 per cent]. “Other frequently recommended products were St John’s Wort [11 per cent] and valerian [15 per cent]. However, there is no good evidence they help with stress, though valerian may help with stress-related insomnia.”

The Pharmacy Guild says it believes consumers must have access to objective, informed advice about CMs, and that a community pharmacy is by far the best place to get that advice, but it doesn’t believe pharmacies should support or promote the use of homeopathic products.

“At the Guild we believe it is essential that consumers have access to objective, informed advice about complementary medicines, and by far the best place to obtain that advice is at a community pharmacy, Guild Executive Director David Quilty stated in the latest Forefront newsletter.

“Four Corners described complementary medicines as a $4.7 billion industry – and it’s not going away, no matter how much its detractors huff and puff. “Consumers want reliable information about complementary medicines, and so do pharmacists. Consumer research clearly shows that consumers expect community pharmacies to stock these products in an environment where they are able to seek advice from a trusted health professional.

“The constructive message to emerge from the Four Corners program was that the evidence base and labelling of therapeutic products are areas where we can improve our already world-class regulatory system – for the benefit of all.

Responding to the Four Corners program, a Department of Health spokesperson said: “The reform of the CM regulatory framework was discussed on the ABC [Four Corners] episode, ‘Swallowing it’. The TGA would test the efficacy [of products] and the company would be able to say this product has been TGA tested, and has passed.

“They will carry some form of indication that they’ve been tested for safety, and efficacy, whether it’s a sticker, whether it’s words, is still there to be discussed both with stakeholders and government.

“And we expect that, by about April, we’ll be able to go to the [Health] minister and other ministers, and say, ‘These are the options we’ve put in front of stakeholders … whether it’s a tick, whether it’s a symbol, or whether it’s some wording about the product having been tested’.”

The Australian Self Medication Industry (ASMI) also addressed the issue, stating it supports measures that build evidence for CMs and help increase compliance to regulations, and therefore welcomes and supports the regulatory reforms proposed in the recent Medicines and Medical Devices Review (MMDR).

“The MMDR recommends alternative measures to advertising pre-approvals to improve compliance, but ASMI believes it would be sensible to see how effective these measures are in practice before abolishing the current system, which we believe is an important compliance measure,” ASMI CEO Deon Schoombie said.