Homeopathy at Boots: an open letter

In a move reminiscent of the very successful Australian Skeptics open letter to pharmacists, the Merseyside Skeptics Society has issued an open letter to Boots pharmacies.

This is in the wake of a parliamentary subcommittee meeting on the status and labelling of homeopathic remedies sold in pharmacies ("chemists" in this country). If you have time, check out the transcript here - a long but interesting read. (Thanks to Mike for the heads-up.) Here's Ben Goldacre's summary, as one of the people who gave evidence at the meeting.
Boots sells homeopathic products. By association, it lends medical authority to these products - which have been demonstrated, so far as good research is able to demonstrate, to be medically indistinguishable from placebos. That is, they are not real medicine, and do not replace real medicine. The will not protect you from malaria; they will not protect you from H1N1. They won't even cure your headache. If your headache does get better after homeopathy, there are three much more likely explanations: (1) it was a random coincidence (unsatisfying, but sometimes the world works that way), (2) it was going to get better anyway (you can't tell this from a single case, but a large study of many people could), or (3) your belief in the treatment had a real effect on your malady (a very cool possibility - see Ben Goldacre's book Bad Science for more, or go read his blog).

Though they sell them, the Boots representative who spoke to the committee admitted that homeopathic treatments have no good evidence supporting their effectiveness in dealing with any health complaint. His best argument for selling homeopathy comes out in this excerpt from the start of the transcript:

Mr Bennett: We do indeed sell them and there is certainly a consumer demand for those products.

Q4 Chairman: I did not ask you that question. I said do they work beyond the placebo effect?

Mr Bennett: I have no evidence before me to suggest that they are efficacious, and we look very much for the evidence to support that, and so I am unable to give you a yes or no answer to that question.

Q5 Chairman: You sell them but you do not believe they are efficacious?

Mr Bennett: It is about consumer choice for us. A large number of our consumers actually do believe they are efficacious, but they are licensed medicinal products and, therefore, we believe it is right to make them available.

Q6 Chairman: But as a company you do not believe that they necessarily are?

Mr Bennett: We do not disbelieve either. It is an evidence issue.

They don't have good evidence that they work, but people want to spend money on them. This is a disgustingly cynical attitude toward the public, and toward Boots pharmacists' own responsibility as front-line dispensers of medicine.

I include the open letter below. I will also be contacting Boots. If you are interested in this issue, I encourage you to do the same.

An Open Letter to Alliance Boots

The Boots brand is synonymous with health care in the United Kingdom. Your website speaks proudly about your role as a health care provider and your commitment to deliver exceptional patient care. For many people, you are their first resource for medical advice; and their chosen dispensary for prescription and non-prescription medicines. The British public trusts Boots.

However, in evidence given recently to the Commons Science and Technology Committee, you admitted that you do not believe homeopathy to be efficacious. Despite this, homeopathic products are offered for sale in Boots pharmacies – many of them bearing the trusted Boots brand.

Not only is this two-hundred-year-old pseudo-therapy implausible, it is scientifically absurd. The purported mechanisms of action fly in the face of our understanding of chemistry, physics, pharmacology and physiology. As you are aware, the best and most rigorous scientific research concludes that homeopathy offers no therapeutic effect beyond placebo, but you continue to sell these products regardless because “customers believe they work”. Is this the standard you set for yourselves?

The majority of people do not have the time or inclination to check whether the scientific literature supports the claims of efficacy made by products such as homeopathy. We trust brands such as Boots to check the facts for us, to provide sound medical advice that is in our interest and supply only those products with a demonstrable medical benefit.

We don’t expect to find products on the shelf at our local pharmacy which do not work.

Not only are these products ineffective, they can also be dangerous. Patients may delay seeking proper medical assistance because they believe homeopathy can treat their condition. Until recently, the Boots website even went so far as to tell patients that “after taking a homeopathic medicine your symptoms may become slightly worse,” and that this is “a sign that the body’s natural energies have started to counteract the illness”. Advice such as this directly encourages patients to wait before seeking real medical attention, even when their condition deteriorates.

We call upon Boots to withdraw all homeopathic products from your shelves. You should not be involved in the sale of ineffective products, because your customers trust you to do what is right for their health. Surely you agree that your commitment to excellent patient care is better served by supplying only those products whose claims can be substantiated by rigorous scientific research? Or do you really believe that Boots should be in the business of selling placebos to the sick and the injured?

The support lent by Boots to this quack therapy contributes directly to its acceptance as a valid medical treatment by the British public, acceptance it does not warrant and support it does not deserve. Please do the right thing, and remove this bogus therapy from your shelves.

Yours sincerely,
Merseyside Skeptics Society

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Other blogs and websites have noted this, including Skepchick, The Not Quite So Friendly Humanist, Bruce Hood, Bad Science, A Glasgow Skeptic, RichardDawkins.net, Bad Homeopathy, and New Humanist.

Also, various newspapers have picked up on Boots' strange position: The Telegraph, Daily Express, Daily Mail, Guardian (and Ben Goldacre again, and their liveblog of the meeting), Times, and Mirror.

Feel free to comment and link to any I've missed.