The Guardian - US healthcare

Hearings to conclude on Tuesday into whether reported concerns including loss 
of sense of smell are cause for greater regulation of booming industry
Homeopathic remedies

[Homeopathic remedies typically contain highly diluted concentrations of their 
active ingredient, leading critics to claim they are little more than sugar 
pills. Photograph: Peter Macdiarmid/Getty Images]

Rory Carroll in Los Angeles
Tuesday 21 April 2015 08.57 EDT
Last modified on Tuesday 21 April 2015 09.14 EDT

Sceptics consider homeopathy a joke, a bogus science that belongs in a 
punchline, not a pharmacy – but US government regulators are suddenly taking it 
seriously.

The US Food and Drug Administration (FDA) is holding public hearings this week 
to explore whether it should toughen oversight of what has become a 
controversial, billion-dollar branch of the healthcare industry.

Critics have long called for greater scrutiny and regulation of homeopathic 
remedies that make bold healing claims and and fill pharmacy shelves alongside 
conventional drugs.

“I hesitate to call these remedies ‘drugs’. They’re mostly sugar pills,” said 
Jim Underdown, the executive director of the Los Angeles branch of the Center 
for Inquiry, a nonprofit that advocates secularism and science, and made a 
presentation to the FDA panel on Monday. “People seem to think they actually 
have medicinal value, but all the science points to that not being true.”

The FDA invited consumers, patients, caregivers, healthcare professionals and 
industry groups, among others, to make oral and written submissions “about the 
current use of human drug and biological products labeled as homeopathic”, as 
well as the agency’s regulatory framework for such products.

The hearings, held in Silver Spring, Maryland, conclude on Tuesday. They offer 
a rare official forum for advocates and foes, and some who hold a halfway 
position, to argue over a fast-growing industry. In 2007, according to a 
Centers for Disease Control survey, 3.3 million Americans spent $2.9bn on 
homeopathic treatments.

Homeopathy, pioneered in the 18th century by German physician Samuel Hahnemann, 
operates on the basis that “like cures like” – that heavily diluted versions of 
substances which cause ailments can cure the same ailments.

Under current FDA enforcement policies, issued in a 1988 policy guide, 
homeopathic remedies can reach pharmacy shelves without official safety and 
efficacy evaluation.

The agency is now reviewing that policy in light of the “dramatic increase in 
the homeopathic product marketplace over the last 25 years”, it said in an 
emailed statement.

Another factor was concern about “significant safety issues” in recent years, 
including more than 130 reports of loss of sense of smell associated with the 
use of three over-the-counter cold remedies, and a warning about Hyland’s 
Teething Tablets because of inconsistent levels of belladonna.

A third reason, said the FDA statement, was availability of more scientific 
data. Studies in Australia, Britain and the United States have found little 
evidence that homeopathic remedies work.

In a submission on Monday, Adriane Fugh‐Berman, associate professor of 
pharmacology and physiology at Georgetown University medical center, said 
classical homeopathy, which seeks to match a patient’s ailment with a single, 
personalised remedy, should not be a regulatory concern.

However, most remedies were pre-mixed and sold over the counter to consumers 
who often confused them with dietary supplements and conventional medicine, she 
said. “The dangers of selling prescription drugs as homeopathic remedies are 
obvious. Allowing homeopathic remedies to sit side‐by‐side with conventional 
drugs that have undergone FDA scrutiny as over‐the‐counter drugs is inherently 
misleading.”

Luana Colloca, an associate professor in anaesthesiology at the University of 
Maryland, speaking to the Guardian after she addressed the panel, said she did 
not favour homeopathic remedies for serious diseases but said they “could be 
acceptable” for minor ailments, even if any benefit was “probably” just a 
placebo effect.

Colloca said lack of dialogue between the pro- and anti-homeopathy camps 
hindered patient awareness of best treatment options. “I think integration of 
the two systems could be very helpful for the patients.”

Homeopathy representatives defended their industry and the existing 
regulations, saying there was no need for a dramatic shakeup.

“Consumers most likely to buy homeopathic medicines are committed to their 
health and devote considerable research effort in evaluating healthcare 
choices,” said an American Association of Homeopathic Pharmacists submission.

“Consumers who have used homeopathic medicines highly trust their prescribing 
physician because of their personal experience, the safety profile, the low 
cost of the medicine and the consistent quality of homeopathic products,” said 
Lisa Amerine, of the Homeopathic Academy of Naturopathic Physicians.

Homeopaths around the US are following the hearings with apprehension, unsure 
if they will lead to onerous FDA regulations. “I am nervous,” said Avghi 
Constantinides, who runs the Los Angeles School of Homeopathy, which offers a 
three-year course.

She defended the safety and efficacy of trained homeopathic treatment, but 
lamented that “weekend warriors” with little training and dodgy certificates 
were tainting the industry. “Some people do a weekend course and call 
themselves homeopaths. It’s very frustrating.”

US weighs crackdown on homeopathic remedies over 'significant safety issues' 
http://www.theguardian.com/us-news/2015/apr/21/fda-homeopathic-remedies-regulation-hearings
 
 
 
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