At 10.23am last Saturday, anti-homeopathy demonstrators staged a mass ‘overdose’ across the country. Chris Chapman asks if pharmacists should stop selling these remedies 

Last Saturday, at 10.23am, protesters congregated outside branches of the UK’s largest multiple pharmacy chain, Boots, to demonstrate against its sale of homeopathic products. The sceptics quaffed whole bottles of homeopathic remedies to show their lack of faith in the treatment.

It is time, they demanded, for pharmacies to stop selling a medical product that the RPSGB says is backed by no scientific evidence.

There is no doubt homeopathy in the UK is big business, with around £40 million in over-thecounter sales from providers, including pharmacies, every year. Of this sum, around £150,000 comes from the 26,000 NHS prescriptions written for homeopathic products.

The NHS is estimated by the British Homeopathic Association to spend a total of £4m on homeopathy, including running four homeopathic hospitals.

But the RPSGB says there is no evidence to support homeopathy.

In November, the RPSGB’s chief scientific adviser Jayne Lawrence stated there was “no scientific basis” for homeopathy at a meeting of the House of Commons Science and Technology Committee.

“We believe there is not any clinical or scientific evidence supporting their [homeopathic products’] use,” professor Lawrence added. “In randomised controlled trials, I categorically say it does not work.” Last year the Society also issued ethical guidance over the use of homeopathy for malaria prophylaxis.

The Society recommended that pharmacists ensure patients “are aware of the risks” of not using recognised medicines.

The Faculty of Homeopathy, which represents health professionals who practise homeopathy, also does not recommend homeopathy for malaria prevention as “there is no scientific proof” it is effective.

The overall guidance from the Society, however, is less clear-cut. It states pharmacists who offer homeopathy should consider referring a patient to a GP if the condition is serious, and not make  any claims about the treatment’s effectiveness. However, it does not state pharmacists should refuse to offer the remedies.

With the efficacy of homeopathy in doubt and the NHS moving toward evidence-based medicine, it seems hard to justify selling homeopathic products. But pharmacist Geoff Ray, whose Total Health Pharmacy in Watton, Norfolk, sells the products, says it’s not the complete picture. He argues that even if there is just a placebo effect, it is the results that matter.

“Nobody can explain the science,” Mr Ray says. “But looking holistically, it has a huge effect on perceptions… done properly it can have a benefit. If that is psychosomatic, then so what?” Boots superintendent Paul Bennett concurs. He says although there is no evidence homeopathy works, it is important to offer patients choice. “We know that many people believe in the benefits of complementary medicines,” Mr Bennett says. “We aim to offer the products we know our customers want.” Mr Bennett points out that homeopathy is recognised by the NHS, and that it would be wrong to deny a regulated product to patients who believe it works.

“From a community pharmacy retail point of view, we rely very heavily on the regulatory process to indicate to us which products are approved and safe for sale,” he told the House of Commons Science and Technology Committee.

But the MHRA is focused on the safety of products, not their effectiveness. Chief executive Kent Woods says that the low risk involved in patients taking homeopathy means the drugs watchdog is less concerned with whether the product works.

“The fact that the level of risk is perceived to be very low makes us a little less stringent than we would be in the conventional sphere in the evidence for efficacy,” Mr Woods told the Commons committee.

The government is also hesitant about taking a stand. According to health minister Mike O’Brien, the government has spent almost £1m on trying to set up regulation of homeopathy. But he insisted, when giving evidence to the committee, that it is not the government’s place to decide whether pharmacists and GPs should offer the therapies.

“We take the view as ministers that it is not our job in relation to this, which is a somewhat controversial area… to stop clinicians who take the view they want to prescribe it, from doing so.” Homeopathy regulation is trapped on a merry-go-round. While many agree there is no evidence it works, nobody is prepared to take a stand and stop the ride. Pharmacists argue it should be up to the MHRA and government to apply the brakes; the players at the top of the NHS are reluctant to make the call.

Mike O’Brien told the Commons committee the NHS’s continued support for homeopathy is not about justifying the treatment, but about justifying the choice to stop funding.

And with both health chiefs and pharmacy passing the buck, it looks as though the sector may continue supplying a treatment with no evidence base for some time yet.