The Quackometer » boots the chemist

Dispensing with Homeopathy: A Proposal

Le Canard Noir — Wed, 03 Feb 2010 23:07:00 +0000

Let’s run with an idea and see where it goes.

The 10:23 campaign has now had loads of publicity and Boots have failed to address any of the central concerns: mainly, that homeopathy is a daft pseudoscience. Moreover, the pharmacy profession and the drugs regulator have remained silent.

In all likelihood, Boots will not withdraw their sugar pills and pharmacists will continue to take your money in exchange for pseudo-medicine. An immediate capitulation was never on the cards – the world does not work like that. But the Boots brand has been damaged as thousands of people have become aware of just what they are prepared to sell you in order to make money.

And let us also take on board the homeopaths argument that banning homeopathy would ‘restrict customer choice’. (Even though 10:23 did not seek to ‘ban’ homeopathy, only remove it from the pharmacy counter and, perhaps, into the health food shop next to the crystals.)

The campaign was really about making sure people understood what homeopathy is: it is not a herbal medicine, as herbs are often not used and any content gets diluted to the point where there is often nothing left. You are buying sugar pills that have had ritual magic performed on them.

As I have said, the villains here are the medicine regulators who allow deceptive labelling of these products. The MHRA say that they test the labels to make sure the public understand what they are buying. This is not true, as their recent submission to the House of Commons revealed. Nothing in their testing asked if customers understood they were buying pills that stated they contained an ingredient but that actually contained nothing, and that there was no reason to believe the pills did anything other than act as a placebo.

The legal blogger Jack of Kent has done a superb job of deconstructing the language on the labels.

Other industries have to battle with the problem with how to convey important information to the consumer that may affect buying considerations based on health: notably the food industry. In the last few years we have seen ‘traffic lights’ highlighting, for example the amount of salt in a ready meal.

Why shouldn’t the packaging of items in the pharmacy not be subject to the same clear labelling requirements?

As Edzard Ernst, Professor of Complementary medicine, has said,

My plea is simply for honesty. Let people buy what they want, but tell them the truth about what they are buying. These treatments are biologically implausible and the clinical tests have shown they don’t do anything at all in human beings. The argument that this information is not relevant or important for customers is quite simply ridiculous. If [pharmacists] are unable to stick to their ethical code, then they should change their code and be clear that it is alright to put profits before patients.

If we were expecting pharmacists to be honest, what would a typical homeopathic product label looks like? I suggest the following:

This quickly gets the key facts across that distinguish the product from others that might have survived some testing. After reading this, most people ought to be able to make an informed decision, and if you are the sort of person who uses crystals for deodorant then you still have your ‘right’ to buy this stuff. Everybody is happy.

Could we ever see such labelling? Somehow I doubt it, for a number of reasons.The government appears to be incapable of taking a position on pseudoscience. Indeed it has recently said that “The government does not find it helpful to define pseudoscience.”

I am sure the businesses behind the pharmacies would resist such a move fiercely as it might be difficult to see how any reasonable person would purchase a product labelled as such. The pharmacists would undoubtedly resist it as it would expose them as having being flogging worthless shit for years. Plus, their ranks appear to be filled with supporters of pseudomedicines. The recently departed president of the Royal Pharmaceutical Society of Great Britain, the regulatory body of pharmacists, is now doing this. (Please empty your mouth of liquids before clicking link as otherwise your screen will get wet.)

Plus, and this is a big one, I would imagine that the majority of products for sale in a pharmacy such as Boots, homeopathic, complementary or regular, would be more likely to have red circles than green ones.

The fact that we could, in principle, have such a scheme and the distance we appear from being able to adopt something like this tells us how little our modern pharmacies have progressed from the quack’s apothecary of old.

***********************************************************************************

Update

Thanks to Richard’s suggestion in the comments that the homeopathy in Boots simply be moved to a section labelled ‘Placebos’.

Of course we get into a dilemma then when the professionals tell you they are giving you a placebo as is so well observed in the (hugely underrated) Smack the Pony sketch…

10:23, Homeopathy and the Shame of the Pharmacy Profession This Saturday, hundreds of people, in many cities, will be demonstrating outside Boots the Chemists about their selling of homeopathic remedies. Each volunteer will be taking a homeopathic ‘overdose’...
Boots Giving Away Worthless Therapies Thanks to Lee Warren, the Purple Magician, who saw this in King’s Cross, London. Trust Boots to be complete idiots. Double Idiots. ...
The Bleakest Day for Homeopathy The much anticipated House of Commons report into the Evidence Check on Homeopathy has now been published and it may well be the report that changes the face of...

Boots Giving Away Worthless Therapies

Le Canard Noir — Tue, 04 Aug 2009 23:07:00 +0000

Thanks to Lee Warren, the Purple Magician, who saw this in King’s Cross, London.

Trust Boots to be complete idiots.

Double Idiots.

Boots the Quack I have recently been accused of working for the ‘drug industry’ and just picking on the ‘little guys’ who are using gentle, more human, and less capitalist healing methods. Well,...
Do Hedgehogs Give My Cat Acupuncture? I thought my post on Reiki Healing for Hedgehogs was going to be a one-off. But a recent trip to the garden centre has opened up a whole new compost...
Boots Maternity TENS Machines. Do they work? So, in a few weeks, Quackometer Manor will have a new arrival, and like all good middle class parents-to-be, we are currently attending compulsory NCT classes, to learn all the...

The Dilemma of Finding Reliable Health Advice Online

Le Canard Noir — Wed, 07 Mar 2007 20:22:00 +0000

A press release today from the Economic and Social Research Council talks about recent research on how the public evaluates the information on health websites. The concluding message is simple:

When searching for health advice online, consumers often reject websites with high quality medical information in favour of those with a human touch.

This is not good news for NHS sites, drug company sites and other sites that might try to stick to the facts for whatever reason. Sites favoured by the subjects in this research were those that included stories from people with similar conditions who had used the particular advice or products, in other words, sites with lots of testimonials. The public quickly reject sites with adverts on, such as on drug company sites. This is in spite of the fact that the researchers found these sites to be quite reliable. This is not surprising considering how tightly regulated such companies are. Telling porkies when you are Big Bad Pharma often gets found out and costs millions.

More surprising is the rejection of NHS sites. Essentially, these were seen as being too boring. It looks like it is all about having plenty of personal stories on your site. You have to be more ‘Hello!’ and less ‘Newsnight’.

The researchers were worried about the results of these findings,

“The tendency to particularly trust sites that contain contributions from like-minded peers could have dangerous effects on some groups of consumers, such as those with anorexia, by reinforcing unhealthy behaviour patterns”,

explained Professor Briggs. I would add another concern. Relying on testimonials and anecdotes leaves the consumer defenseless in the face of quackery.

Professor Briggs has drawn up a set of guidelines for sites if they want to be noticed by consumers. These include the “use [of] engaging stories about people with similar experiences”.

“The great strength of the Internet is that you can find people who have had the same problem that you have and see how they have coped with it – to forget about that, or to act as if it’s not happening, is missing the point.”

But that is exactly how quacks make their living. By relying on the unwary to believe the testimonials they have about their products.

Any quack can find testimonials. The mind-tricks behind the placebo effect and cognitive biases mean that it does not matter how stupid your proposed cure is, someone, somewhere will endorse it for you. If you can find one person to endorse it, then you can find many. In addition, most quacks can find a celebrity or two to add their testimony behind the product and really add to its credibility. Just look at today’s top ten quack pages on the quackometer. You will find a testimonial rich environment and an evidence free zone.

If I were to compile a list of how to spot a quack web site, near the top would be “Look out for an over-reliance on testamonials”. If reliable health advice sites were to adopt the same strategy, then this rule of thumb would be useless.

Spotting good websites is hard. Of course, having good references to independent and reputable peer-reviewed journals is important, but may be too difficult for most people to evaluate. Sense about Science, the UK charity, try to educate people, mainly journalists, on how to spot good evidence on sites. Maybe ‘brands’ like the NHS could make better use of showing more testamonials, but even the NHS can be seen to be endorsing state-sponsored quackery. High street brands like Boots and Holland and Barret are of course in league with the quack, selling all sorts of dodgy products. A real dilemma.

Of course, I would say that all you have to do is install the quackometer toolbar button in your browser. When you find yourself on a suspect website, hit the button and the quackometer will alert you to potential nonsense.

I wish it was that simple.

RSS Quack Alert Feeds Now Added You can now subscribe to RSS Feeds to get all the Quackiest Stories direct to your browser without scanning the news sites and papers yourself. The News Alert Engine is...
Advances in Quackometrics – News Alerts The latest quackometer functionality is now being tested on the quackometer web site. Throughout the day, the little black duck will be reading the news for you and creating alerts...
The Quest For The Perfect Quack! Well, I’ve had a bit of time to put some effort into the Quackometer, and now it has a few new features and improvements. 1. First – ‘Am I a...

Boots the Quack

Le Canard Noir — Tue, 29 Aug 2006 13:22:00 +0000

I have recently been accused of working for the ‘drug industry’ and just picking on the ‘little guys’ who are using gentle, more human, and less capitalist healing methods. Well, as I say in my definition of quackery, quack thinking can come from all quarters and all sides of the orthodox/alternative medicine camps.

‘Big Pharma’ is a word that is pejoratively used to criticise drug companies in their pursuit of profits by their stubborn refusal to embrace alternative thinking. Their profits depend somehow on them denying the legitimacy of any alternative treatment. Alternative therapies are somehow more suitable for the small practitioner who may not even be that interested in making money – apparently.

The evidence would suggest that this is not so clear cut. Alternative medicine is also huge business with people spending millions on it every year. UK Skeptics believe that is is a £1 billion per annum business in the UK. Whilst I am not sure of the exact figures, a scout around your local high street reveals a growing alternative medicine presence. What town centre these days is not complete without its Dr & Herbs, Holland and Barrett and equivalents? As we walk down the street, the shop windows are encouraging us to pop unnecessary vitamins in our gobs, create mild vacuums on our skin to draw out ‘toxins’ (or something), imbibe flower extracts and stick candles in our ears.

Holland and Barrett is not a small business. It is part of the American Drug conglomerate NBTY. Their description on their web site is that:

NBTY is a leading vertically integrated manufacturer and retailer of a broad line of high quality, value-priced nutritional supplements in the United States and the United Kingdom.

The company is currently listed as about the 800th largest firm in the US, has a market capitalisation of about $2 billion and is in the top twenty pharmaceutical firms in the US. In the UK, it is cheerfully endorsed in adverts by that 80’s pop star favourite, Kim Wilde. This is a company that is quite happy to make a healthy living by selling products that trade on the myths of ‘natural’ and ‘alternative’.

But is just not the ‘health’ food shops that cash in on alternative medicine. Boots the Chemist is the largest and most respected high street chemist in the UK. It is something of a national institution and is seen as a reliable, trustworthy retailer. More the shame then that it has a large voodoo section next to its other medicines. It sells a full range of food supplements, herbal cures and copper bracelets, much as Holland and Barrett does. It also, has a nice section devoted to Bach Flower Remedies and, most gallingly, homeopathy remedies, both branded and own brand.

Now homeopathy has been aptly described as the pons asinorum (the bridge asses have to cross) of alternative medicine. If you struggle to see why homeopathy is utter nonsense and that claims made of it are ridiculous, then we are not going to get much further on our journey together.

Homeopathy is based on two so-called laws:

The Principle of Similars – like causes like – re-create the symptoms of the disease somehow and you can cure the disease.
The Law of Infinitesimals – the more dilute an ingredient is the greater the effect it will have.

A Dr Hahnemann (1755-1843) dreamed up these laws. In the two hundred years since his inspiration, no one has managed to show that they are indeed true. In fact, the massive advancement in science since then would suggest only one thing – that these so-called laws should be dumped in the great landfill site of bonkers ideas and covered in seagull shit.

The dilution of homeopathic treatments is really the most ridiculous part. In Boots, preparations are available that are labelled as 30C. This means that the original substance has been diluted to the extend that it is impossible that any active ingredient remains. If you look a the contents label of each ‘medicine’, Boots actually admit it. In each pill there is nothing but sugar. You might as well pop next door to Woolworths and pick up some Smarties – at least you would get some chocolate.

This means that if you went into Boots and emptied all the pills on the floor, there is not an analytical technique in the world that could tell the pills apart. No amount of measurement would tell you which was which. There is not a machine sensitive enough and no nano-measurement technique that would spot any active ingredient. They are identical. Just expensive sugar pills. You really have to wonder if Boots goes to all the trouble and expense of going through the shamanic ritual of diluting the supposed active ingredient to the required level when they could just scoop a tub full of generic pills into an appropriately labelled pot. No-one would ever know the difference.

So, either all of physics and chemistry is horribly wrong or homeopathy is utter quackery. Place your bets.

But what if I am wrong? People do say it works – they can’t all be wrong. Maybe. All the effects of homeopathy can be attributed to the placebo effect. When properly controlled large trials of homeopathy are done, using double-blind randomised techniques, you cannot tell placebo groups from homeopathy groups. Its just sugar pills as we thought.

So, what happens when you write to Boots saying that you are disappointed in their promotion of quackery? Well, you get a letter back like this one I received a little while ago…

Thank you for your recent e mail.

I am sorry to hear that you feel unable to shop with us because we sell homeopathic products and other alternative remedies.

Boots prides itself on offering customers choice and, whilst some people may not believe in the products, a large number of our customers continue to find homoeopathy products beneficial for them.

Whilst this is the case and whilst the MHRA, the government’s own regulatory body, continue to regard the product as medicines that are safe for our customers to use, we will continue to offer them in our shops.

I hope this explains our decision to stock this type of product.

Thank you again for taking the trouble to e-mail us.

Kind regards.

Boots Customer Care
PO Box 5300
Nottingham

If you respond to this email pointing out your unhappiness with this answer then silence ensues.

So what are Boots saying here?

Boots prides itself on offering customers choice
Obviously, choice is good, even if the choice made might be a very bad one.

whilst some people may not believe in the products
Like the whole of medical science, physics and chemistry and I would wager most of your own pharmacists and scientists.

a large number of our customers continue to find homoeopathy products beneficial for them
How beneficial? About as beneficial as a smarty would be my guess. If you have proof of efficacy over and above this then your scientists will be up for a Nobel Prize in Medicine.

Whilst this is the case and whilst the MHRA, the government’s own regulatory body, continue to regard the product as medicines that are safe for our customers to use
No-one is disputing their safety! If they were dangerous, that would be as much as a miracle as if they worked. What is dangerous is Boots giving these pills an endorsement that may discourage people from seeking proper care.

we will continue to offer them in our shops
whilst sections of the public are uninformed enough to buy them, it is not illegal, and we can make big bucks from little bits of sugar.

I hope this explains our decision to stock this type of product.
Yep, you’ve said it all.

Thank you again for taking the trouble to e-mail us.

If you are outraged by Boots actions too, why not drop them some feedback at this URL?

Boots Giving Away Worthless Therapies Thanks to Lee Warren, the Purple Magician, who saw this in King’s Cross, London. Trust Boots to be complete idiots. Double Idiots. ...
Dispensing with Homeopathy: A Proposal Let’s run with an idea and see where it goes. The 10:23 campaign has now had loads of publicity and Boots have failed to address any of the central...
10:23, Homeopathy and the Shame of the Pharmacy Profession This Saturday, hundreds of people, in many cities, will be demonstrating outside Boots the Chemists about their selling of homeopathic remedies. Each volunteer will be taking a homeopathic ‘overdose’...