MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

It has been reported that ‘Boots the Chemist’ have filed several legal complaints against The Guardian in relation to articles published by the paper in relation to its April 2016 investigation. The Guardian articles in question alleged that Boots, the UK’s largest pharmacy chain, had placed undue pressure on its pharmacists to perform medicines use reviews so that it could claim the maximum payments possible from the NHS. In other words, The Guardian implied that Boots was trying to get more money from our NHS than might have been due.

Personally, I am always uneasy when I hear that someone takes legal action on such matters. I think that legal complaints of such a nature can turn out to be counter-productive, both in general and in this particular instance.

Why?

There could be several reasons. For instance, such actions might give someone the idea of filing complaints against Boots. I am sure it is not difficult to find reasons for that.

In the realm of alternative medicine, for example, someone might question whether selling homeopathic remedies in Boot’s section ‘pharmacy and health’ is not misleading. These remedies might be seen by a naïve customer as masquerading as medicines. As readers of this blog know all too well, they do not, in fact, contain anything (other than lactose) that has any pharmacological activity. Therefore Boots should best market them in the category of ‘confectionary’.

One might even suspect that Boots are fully aware of all this. After all, a spokesperson for the company stated years ago during a parliamentary inquiry: “I have no evidence to suggest that they [homeopathic remedies sold by Boots] are efficacious …”

And it is also not the first time that Boots have been challenged for selling products they know to be placebos. This is what The Guardian reported in 2008 about the issue: “Ernst accuses the company [Boots] of breaching ethical guidelines drawn up by the Royal Pharmaceutical Society of Great Britain, by failing to tell customers that its homeopathic medicines contain no active ingredients and are ineffective in clinical trials.”

A similar void of evidence also applies to Boot’s wide range of Bach Flower Remedies and aromatherapy oils.

Or am I wrong?

Perhaps Boots want to post links to the evidence in the  comment section below?

I am always keen to learn and only too happy to change my mind in view of new, compelling evidence!

Boots also sell a very wide range of herbal medicines, and here the situation is quite different: herbal medicines actually contain molecules that might have pharmacological effects, i. e. they might heal or might harm you. And many of these products imply indications for which they should be taken. I will pick just one example to explain: HERBAL SLIM AID.

Yes, you are absolutely correct – this product is (according to its name) not for gaining weight, it’s for reducing it. Each coated tablet contains 45 mg of extract (as dry extract) from Bladderwrack thallus (Fucus vesiculosus L.) (5:1) (equivalent to 225 mg of Fucus) Extraction solvent: water, ,30 mg Dandelion Root (Taraxacum officinale Weber ex Wigg), 27 mg of extract (as dry extract) from Boldo leaf (Peumus boldus Molina) (4-6:1) (equivalent to 108-162 mg of Boldo leaf) Extraction solvent: Methanol 70% v/v, 10 mg Butternut Bark (Juglans cinerea L.).

Now, I thought I know quite a bit about herbal slimming aids, after all, we had a research focus on this topic for several years and have published about a dozen papers on the subject. But oddly, I cannot remember that this mixture of herbs has been shown to reduce body weight.

Perhaps Boots want to post evidence for the efficacy and safety of this product as well?

I certainly hope so, and I would instantly withdraw any hint of a suspicion that Boots are selling unproven or disproven medicines.

Where is all this going?

I have to admit that am not entirely sure myself.

I suppose all I wanted to express was that it might be unwise to throw stones when one is sitting in a glass-house – a cliché, I know, but it’s true nevertheless.

 

 

 

CONFLICTS OF INTEREST:

None [except I don’t like those who easily take legal action against others]

7 Responses to Boots the Chemist, legal complaints, and alternative medicines

  • The Boots Herbal Slim Aid Tablets product is made by Potters and has an MHRA Traditional Herbal Registration, THR 44893/0028.

    As a THR, licencing requires no evidence of efficacy, just evidence of ‘traditional use’. In fact, if there was evidence of efficacy, a THR cannot be issued.

    • Just for clarity, this requirement originates in Chapter 2a Specific provisions applicable to traditional herbal medicinal products, Article 16a, of EU Directive 2001/83/EC (as amended):

      3. However, in cases where the competent authorities [in the UK, this is the MHRA] judge that a traditional herbal medicinal product fulfils the criteria for authorisation in accordance with Article 6 [full Marketing Authorisation] or registration pursuant to Article 14 [homeopathic products], the provisions of this chapter shall not apply.

      • so, there is no evidence of efficacy [and none required]; what about evidence of safety? what about interactions between the multiple ingredients\/

        • For example, I would like to know, whether it is safe for people with thyroid disorders to consume bladderwrack? Maybe there is something behind the traditional use (and if this plant stimulates the thyroid, the weight may drop), but the question is whether the thyroid needs to be stimulated).

        • Odd. I took the THR number form the Boots PIL I linked to, but I’ve just checked the MHRA’s list of THR registrations and it’s not there.

          What is there is:

          THR 33656/0077

          Vifor Pharma UK Ltd

          Potter’s Slim Aid Tablets Boots Herbal Slim Aid Tablets

          Bladderwrack thallus (Fucus vesiculosus L.) Dandelion root (Taraxacum officinale Weber ex Wigg) Boldo leaf (Peumus boldus Molina) Butternut bark (Juglans cineraria L.)

          As an aid to slimming as part of a calorie controlled diet, based on traditional use only.

          This would appear to be the same product, but the number Boots quote is not listed.

          Also, the first part of the THR number is the ID number of the manufacturer, but they differ.

          I’ve asked the MHRA Twitter account @MHRAherbals about this discrepancy.

  • I can imagine the board meeting.

    Suit: “So, the Guardian says, based on apparent whistleblower testimony, that staff are conducting unnecessary medicines reviews. What should we do?”

    Another suit: “Commission an independent audit, which will either prove the Guardian wrong or find out if there is a problem we need to fix?”

    Third suit: “Sue the bastards.”

    First suit: “Sue them! Capital idea. The law is notoriously litigant friendly, isn’t it?”

  • BMA policy has been established in 2008 and 2010 and is:

    “The BMA calls on NICE to review and report on the cost effectiveness of homeopathic remedies and to recommend whether they should continue to be funded by the NHS.” (2008).

    “In the absence of valid scientific evidence of benefit:
    (i) there should be no further commisioning of, nor funding for, homeopathic remedies or homeopathic hospitals in the NHS;
    (ii) no UK training post should include a placement in homeopathy;
    (iii) pharmacists and chemists should remove homeopathic remedies from shelves indicating they are ‘medicines’ of any description and place them on shelves clearly labelled ‘placebos’.” (2010).

    See, ‘Real secrets of Alternative Medicine’ (Amazon) pp. 36, 169, 171, 347.

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