Wednesday, October 27, 2010

UK Govt continues support for Homeopathy despite lack of evidence of efficacy

United Kingdom Parliamentary Committee on Science and Technology was asked to review the efficacy and the policy of Govt funding for Homeopathy last year. On February 22,2010, the committee submitted a report to the Government. The report,one of the most comprehensive evaluation of Homeopathy by a Government Body recommended discontinuation of State funding for Homeopathy.
Here are some excerpts from the report:

...We conclude that the principle of like-cures-like is theoretically weak. It fails to provide a credible physiological mode of action for homeopathic products. We note that this is the settled view of medical science....

....We consider the notion that ultra-dilutions can maintain an imprint of substances previously dissolved in them to be scientifically implausible.....
....In our view, the systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos.....
...There has been enough testing of homeopathy and plenty of evidence showing that it is not efficacious. Competition for research funding is fierce and we cannot see how further research on the efficacy of homeopathy is justified in the face of competing priorities.
 It is also unethical to enter patients into trials to answer questions that have been settled already.

...We do not doubt that homeopathy makes some patients feel better. However, patient satisfaction can occur through a placebo effect alone and therefore does not prove the efficacy of homeopathic interventions...
..For patient choice to be real choice, patients must be adequately informed to understand the implications of treatments.
For homeopathy this would certainly require an explanation that homeopathy is a placebo. When this is not done, patient choice is meaningless. When it is done, the effectiveness of the placebo—that is, homeopathy—may be diminished. We argue that the provision of homeopathy on the NHS, in effect, diminishes, not increases, informed patient choice.

...The Government should stop allowing the funding of homeopathy on the NHS.
We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals—hospitals that specialise in the administration of placebos—should not continue, and NHS doctors should not refer patients to homeopaths.

Govt Response

 Even though the UK Government agreed to most of the points raised by the Committee report,it did not agree to stop NHS funding for homeopathy.Instead the Government is trying to put the ball in the local hospital/clinician's court.

 The Govt response said:
We agree with many of the Committee’s conclusions and recommendations. However, our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians, rather than Whitehall, are best placed to make decisions on what treatment is appropriate for their patients - including complementary or alternative treatments such as homeopathy - and provide accordingly for those treatments.

In its response to the report, the Government also said that it will keep the position on NHS funding under review.
 "However, we believe that providing appropriate information for patients should ensure that they form their own views regarding homeopathy as an evidence-based treatment," it said.

Scientists point out, however, that if patients are told clearly that there is no credible evidence to support homeopathic treatments, this may undermine the only benefit that homeopathy is likely to provide, namely the well-established "placebo effect" where someone feels and gets better because they believe a treatment is working.

My view

I fully agree that Homeopathy is just a glorified placebo. At the same time it has an important role to play in the society as a pseudo scientific placebo [some may compare it with the good effects of God/religion in society]
In Indian situation it is more relevant. With Modern medicine practise as un-regulated as in India misuse of antibiotics is very wide spread. Many self limiting viral infections when presented to a modern medicine practitioner receives an antibiotic prescription.If all such mild illnesses gets treated by a homeopathic placebo,the emergence of antibiotic resistance could be delayed.
Moreover for many mild illnesses modern medicines with varying toxicity profiles are prescribed instead of reassurance. Here a homeopathic consultation will provide reassurance in the form of harmless homeopathic drugs.
  My conclusion is that what ever be its lack of efficacy homeopathy should continue as a harmless placebo.

Parliament Committee report
Govt Response