Friday, March 14, 2008

Filling the Void

I really, really hate seeing pseudoscience in pharmacist-targeted publications. Granted, I'm sure that physicians and other healthcare professionals feel the same way, as evidenced by Orac's feelings about woo in medical schools.

Let it be known that I just flat-out don't like Drug Store News. Drug Store News is a publication that is at least 50% about stuff I totally don't care about. They have some occasional clinical information, or a little bit here and there about how to improve your outpatient practice (say, how to talk to patients with diabetes). The rest of Drug Store News is about how to sell more lip balm and whether or not your drug store should stock chunky peanut butter. It's not a science-oriented publication; it's a business-oriented publication. Because I have absolutely no interest in the "business end" (har har) of pharmacy, all of this seems like a huge step backward to me. If pharmacists are going to spend all their time fighting to be recognized as clinicians instead of shopkeepers, their right hand clearly doesn't have any idea what the left is doing. The left is still very concerned with keeping profit margins high by knowing which Burt's Bees products that the public prefers.

However, I have reason for my annoyance with the publication above and beyond the fact that they don't focus on things that I care about. They, perhaps in the "printing all the news that's fit to print" vein, have no qualms publishing articles about such ridiculous and unproven woo as homeopathy. They regularly advertise homeopathic products, often with several ads per issue, and announce their introduction to the market with the same fanfare that they give to real medications. And I'm not just talking about "homeopathic" products like zinc lozenges, which are marketed as being homeopathic to avoid FDA regulations despite containing comparably large amounts of zinc.

What stunned me was that a recent column was promoting homeopathy as a substitute for drug therapy in children under two due to the recent OTC cough-and-cold withdrawals. Much to my annoyance, I can't find the column replicated on their web site, preventing me from simply linking it, but the highlights of the column were more or less what you might expect from proponents of homeopathy pushing the products as a replacement for the pulled children's medicines.

"Homeopathy is safe," they assert, first and foremost. A definite reassurance needed in a time of uncertainty. The shifting guidelines and need for further research (which will probably never be done) mean that parents are struggling with the idea that they can no longer simply give their children medicine when they're not feeling well. Homeopathy can fill the void for concerned parents--giving them a way to feel like they're helping, even if they aren't. It's certainly easier to give children homeopathic tablets, which are mostly lactose, than it is to try to use a rubber suction bulb to reduce nasal congestion in an infant. But parents will feel better either way. What a seductive marketing promise.

Treating a teething child with homeopathy isn't exactly child abuse, but it is a waste of money. And providing parents with false alternatives to medical treatment is likely to delay the time until children see a physician. You might think that reasonable parents will take the time to go see a doctor, but I've talked to my share of parents who just want to give their poor babies some medicine and avoid a doctor's visit--or worse, the parents who can't afford to take their children to see a doctor, so they really want you to recommend some liquid Tylenol and send them on their way. Which really means that the decision to include homeopathic products on the shelves preys on the poorest and most desperate of parents, those trying to find a way to comfort their children when all other ready alternatives have been removed from their grasp.

It's easy to see why a "drug store" would market homeopathic products. They make money. But is it ethical to market homeopathic "cures"--especially when the tendency is to place them right next to the "real" medicine, where consumers can't tell the difference? In a world where patients tend to choose products based on what's on the front of the box--instead of the back, where the real information is--current marketing practices are nothing but a cleverly designed deception. And that's why a pharmacy shouldn't be doing it.

1 comment:

Abel Pharmboy said...

S.A., I've been using this AJPE article for 10 yrs now to illustrate to Rx students (and their preceptors) the discordance between homeopathy and dose-response pharmacology. If your profs aren't using it, they should. (PDF here).