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

It has been reported that pharmacies in New Zealand continue to ignore a code of ethics that requires them to inform customers, if a product has no evidence of efficacy. The code of ethics states: “Pharmacists must advise patients when scientific support for treatment is lacking.”

Eight Auckland pharmacies were visited to enquire about a homeopathic product for sale. Pharmacy staff were asked what they knew about a homeopathic product on their shelves and if it worked. All failed to share information about the lack of scientific evidence showing the product works. Instead, they claimed that homeopathic solution of arnica sold as a treatment for injuries, bruising and post-surgery trauma “works really, really well”, was “awesome” and could also cure headaches. One salesperson checked with the pharmacist whether the product was suitable for swelling post-surgery and was told it was fine as long as no other medication was being taken at the same time.

There is no credible evidence the highly diluted homeopathic remedies sold by pharmacists work better than a placebo. Homeopathy’s effectiveness has been rejected by many scientists and by large government reviews conducted in the UK, Australia and Europe.

Even if a staff member personally believes a homeopathic product works, guidelines referenced by the code of ethics say this should not sway the information given to the customer: “Patients must be made aware of the likely effectiveness of a given therapy according to recognised peer-reviewed medical publications, in spite of your personal beliefs.”

Shortly after the code was changed in March 2018, Newsroom performed the same secret shopper experiment at four pharmacies and found the new rule was not followed. Eighteen months on, nothing has improved.

The chair of the consumer advocate group the ‘Society for Science Based Healthcare’, Mark Hanna, said there was no excuse for pharmacies to sell this kind of thing without warning. “Pharmacists should know better. Full stop. They should not be misleading their patients, they should not be letting their staff mislead their patients. If they don’t know, that’s incompetence. I would expect to be given reasonable, evidence-based advice, possibly some different options with the reason why I might choose one over the other. I wouldn’t expect to be misled and sold something that wouldn’t work.

Asked why the code was not being followed a spokesperson of the NZ pharmacists said a reminder of the code of ethics had been sent to pharmacies in June. It was recommended all staff be made aware of the code: “We encourage you to share this protocol with your entire team – even though it is a protocol for pharmacists, the reasoning also extends to other staff members in the pharmacy and it is important that all staff ensure that the patient has been provided with sufficient information to make an informed choice.”

By Jove, we have discussed this issue often enough. If you are interested, here are a few of my more recent posts on this subject:

But pharmacists seem utterly reluctant to change – in NZ or elsewhere. Why? Could it have something to do with money?

If doctors violate their code of ethics, they face being reprimanded by their professional body. It is high time that the same happens with pharmacists, I feel.

2 Responses to Pharmacists must advise customers that homeopathic remedies lack evidence

  • I would refer the pharmacists to HRI-research.org

    No doubt you wouldn’t.

  • Sadly, I know of no UK registered medical practitioner who prescribes homeopathic remedies and who advises their patients about the scientific and medical consensus.
    Some of the reluctance to be honest and demonstrate intellectual integrity may be due to wanting to sell remedies to their patients. The Profit Motive.
    Some might be down to wanting to exude an air of supeiority (particularly where those patients who respond to sychophancy are concerned). The Prophet Motive.

    I was preparing a dossier for the GMC identifying Dr Peter Fisher as one who seemed to be in denial and failed to obtain informed consent (contrary to GMC guidance) – but sadly, RIP.

    The issue for the GMC is that in general it only accepts complaints from a patient (or police or another professional concerned that the recalcitrant practitioner might not be fit to practice).
    Patients are disinclined to fess up that they were misguided enough to seek homeopathic care in the first place.

    The issue for pharmacists is that they want to satisfy customers and secure sales.
    The issue for governments is that they want to satisfy the population and secure votes. (Jeremy Hunt endorsed homeopathy.)
    Integrity has left the consulting room, pharmacy, and parliament.
    Sigh.

    But at least David Tredinnick, former MP and homeopathy advocate, is not standing to be elected again.

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