John Dwyer: Complementary storm

ON 30 January, La Trobe University announced that it had signed a memorandum of understanding with the Swisse Wellness company.

The partnership would be a first step in establishing a centre to subject “complementary” medicines to rigid scientific testing for efficacy. Emphasis would be directed at testing Swisse’s own products.

Surely a good news story?

One suspects that the university — or at least its deputy vice-chancellor for research, Professor Ken Nugent — would have been amazed at the immediate storm of criticism that greeted the university’s initiative.

Genuine drama characterised the controversy when the university’s own Professor of Public Health, Ken Harvey, publicly resigned in protest.

He and many other commentators were concerned by the potential conflict of interest, with numerous studies emphasising how such arrangements can, and often do, produce biased results.

Professor Harvey has long been the leading advocate for the use of complementary medicines to be evidence-based and has been a long-time critic of the claims Swisse makes for many of its products. Ironically the university had published his criticisms in its own journal.

Perhaps the most interesting and disturbing questions that emerge from this planned partnership involve the apparent failure of a major university to subject the track record of its proposed partner to “due diligence”.

Why was their “in-house” expert on all things Swisse not consulted? Did the university know that Swisse had been rebuffed when it approached Bond, Monash and Sydney universities with the same deal?

Did La Trobe know that Swisse had been severely criticised for offering GPs financial incentives to supply special versions of their products for sale in doctor’s surgeries?

A Therapeutic Goods Administration (TGA)-sponsored review panel would not accept that studies sponsored by Swisse supported the claims being made in its advertising. Indeed, the panel decided that many of the claims made by Swisse breached the TGA’s advertising code.

It could not be seriously argued that Swisse is really interested in the evidence base for their claims. If they were, why haven’t they asked the TGA for registration rather than listing for their products? Registration requires that any therapeutic claims undergo independent scientific evaluation.

La Trobe’s Professor Nugent, an outstanding physicist, with an enviable and well deserved national and international reputation, took the controversy to the Australian public with an article in The Age, asking consumers if they would like to know if the supplements they are taking are really doing them any good?

This would suggest Professor Nugent knows as little about the myriad of excellent studies on the questions he asked as I know about quantum mechanics and chaos theory. Good science tells us that average Australians taking supplements will get no relief from stress or more energy by taking vitamins and they do not need to regularly detoxify their liver.

Clinical scientists would support an initiative at La Trobe that facilitated the conduct of independent and disinterested scientific evaluations of alternative and/or complementary therapies where the anecdotal evidence for benefit is strong and the proposed method of action is plausible in the light of established knowledge and therefore does not involve pseudoscientific concepts (eg, homoeopathy). After all, this is how scientifically validated therapeutics have been developed and become so important in modern medicine.

The Swisse claims for the contents of its products have been thoroughly tested and found wanting and require no additional research. The Swisse deal should be abandoned.

It would not be fair to suggest that Swisse is the only culprit in misleading Australians about the need for supplements. Many other companies are similarly guilty, if not to the same extent.

Clearly we doctors need to do more to convince Australians that they cannot neutralise an unhealthy lifestyle with supplements and with out-of-pocket health care costs soaring they could collectively save themselves $2 billion a year by only buying these supplements if they are advised to do so by their doctors.
 

Professor John Dwyer AO is the president of the Friends of Science in Medicine and emeritus professor of medicine at the University of NSW.


This is the first of a two-part series by Professor Dwyer on complementary medicine.