A pharmacy journal headline recently proclaimed “$1.8b benefit from [Complementary Medicine] CM”.Based on Potential Health Outcomes & Cost Savings in Australia, a report funded by the Australian Self Medication Industry (ASMI), only one of the six treatments investigated was actually “complementary”, in that they are a useful adjunct to doctor-prescribed therapies. Are claims that CM’s can have “significant economic benefits” misleading?
The journal article focused on the economic effects of calcium and vitamin D in the treatment of osteoporosis. Other CM regimens discussed in the ASMI report referred to cardiovascular disease (CVD), age-related macular degeneration (AMD) and ‘moderate’ major depression (whatever that is).
Time and time again, the CM industry has been caught appropriating the hard work of medical scientists. Often referred to as “well established proof” of the benefits of CM’s, supplements such as iron, calcium, magnesium, folic & omega fatty acids and vitamins are not CM’s. Even though they might be stocked in the ‘natural’ section of your local pharmacy or supermarket, they are conventional medicines. They were discovered and developed by medical and pharmaceutical scientists. It was they, not the CM Industry, who did the hard yards of researching the biochemistry and physiology of their mechanisms of action, before undertaking clinical trials to determine optimal doses and patient populations for each of the nominated diseases. In reality, most CMs don’t work.
While the latest systematic reviews on omega fatty acids concluded that there are no or minor benefits for heart disease because they do not prevent heart attacks, stroke, sudden death and arrhythmias.
However, the correct doses of appropriate clinically-tested supplements might have some potential net health care cost savings and productivity gains, by reducing the risk of broken bones and AMD in appropriate high-risk groups. Of major concern is that there is no mention of potentially harmful effects, for example, with vitamins causing in a slight increase in deaths. Research also shows that almost one in 10 women taking calcium supplements develop hypercalcaemia which raises the risk of kidney stones and cardiovascular disease.Over the past decade, liver injury attributed to CMs has increased significantly.
The only genuine CM mentioned in the report was St John’s Wort. This which does appear to have a modest anti-depressant effect. However, it is not recommended by doctors, as it has significant side-effects and serious interactions with some prescription drugs – an important detail that the CM Industry appears to have difficulty telling patients. It has also resulted in death – which the report also failed to mention!
In a recent audit by the Therapeutic Goods Administration, the majority of CMs were found to have manufacturing or quality problems. Rather than misleading patients by overstating financial gains and taking the credit for the research conducted by hard-working scientists, with up to 90% of their products failing to comply with the standards set by the TGA, perhaps the CM Industry should be encouraging their members to fix their mostly non-compliant goods.