Evidence Check 2: Homeopathy
Evidence Check 2: Homeopathy
The Committee published '
Evidence Check 2: Homeopathy', HC 45, its Fourth Report of Session 2009-10, on Monday 22 February 2010. The report included the oral and written evidence.
MPS URGE GOVERNMENT TO WITHDRAW NHS FUNDING AND MHRA LICENSING OF HOMEOPATHY
In a report published today, the Science and Technology Committee concludes that the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.
The Committee carried out an evidence check to test if the Government’s policies on homeopathy were based on sound evidence. The Committee found a mismatch between the evidence and policy. While the Government acknowledges there is no evidence that homeopathy works beyond the placebo effect (where a patient gets better because of their belief in the treatment), it does not intend to change or review its policies on NHS funding of homeopathy.
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.
The Committee concluded-given that the existing scientific literature showed no good evidence of efficacy-that further clinical trials of homeopathy could not be justified.
In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful.
Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.
The report also examines the MHRA licensing regime for homeopathic products. The Committee is particularly concerned over the introduction of the National Rules Scheme (NRS) in 2006, as it allows medical indications on the basis of study reports, literature and homeopathic provings and not on the basis of randomised controlled trials (RCTs) - the normal requirement for medicines that make medical claims.
The MHRA’s user-testing of the label for Arnica Montana 30C-the only product currently licensed under the NRS-was poorly designed, with some parts of the test little more than a superficial comprehension test of the label and other parts actively misleading participants to believe that the product contains an active ingredient.
The product labelling for homeopathic products under all current licensing schemes fails to inform the public that homeopathic products are sugar pills containing no active ingredients. The licensing regimes and deficient labelling lend a spurious medical legitimacy to homeopathic products.
The Chairman of the Committee, Phil Willis MP, said:
"This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not.
"It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.”
Terms of Reference
In preparation for the establishment of the Science and Technology Committee on 1 October, the former IUSS Committee commissioned work to assess the Government's use of evidence in policy-making. The Committee wrote to the Government on a number of topics and asked two questions: (1) What is the policy? (2) On what evidence is the policy based? The Government has now replied and having considered the responses the Committee has selected Homeopathy for its second Evidence Check.
The Committee invited short submissions on the following issues:
- Government policy on licensing of homeopathic products
- Government policy on the funding of homeopathy through the NHS
- the evidence base on homeopathic products and services.
Monday 30 November 2009
Mr Mike O'Brien QC MP, Minister for Health Services, Department of Health;
Professor David Harper CBE, Director General, Health Improvement and Protection, and Chief Scientist, Department of Health;
Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency
Wednesday 25 November 2009
Professor Jayne Lawrence, Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain;
Robert Wilson, Chairman, British Association of Homeopathic Manufacturers;
Paul Bennett, Professional Standards Director, Boots;
Tracey Brown, Managing Director, Sense About Science;
Dr Ben Goldacre, Journalist.
Dr Peter Fisher, Director of Research, Royal London Homeopathic Hospital;
Professor Edzard Ernst, Director, Complementary Medicine Group, Peninsula Medical School;
Dr James Thallon, Medical Director, NHS West Kent;
Dr Robert Mathie, Research Development Adviser, British Homeopathic Association.
Report to be published