Agency: Pharmacy ban on homeopathic 'medicines' will not help

Pharmacy. Source: OÜ Marja Apteek

Homeopathic remedies are not medicines, but they can be bought at pharmacies and used for conditions that require immediate medical attention. Doctor and parliamentarian Karmen Joller (Reform) wants pharmacies to stop selling such "medicines" but the Medicines Agency says that this will not solve the problem.

Postimees reported (link in Estonian) this week on a case in which a mother used homeopathic remedies to treat her three-year-old child who was dehydrated after vomiting following advice on social media; the child is now hospitalized.

Although homeopathic remedies are not medicines, they can be bought from a pharmacy. Laivi Saaremäel, head of the quality assessment at the Medicines Agency (Ravimiamet), told ERR that she does not see this as a problem, as pharmacies sell a wide range of medical devices, aids, hygiene products, vitamins/supplements and even cosmetics.

"Thus, not all pharmacy commodities are medicines. Homeopathic remedies differ from pharmaceutical medicines in nature and treatment, but they are regulated in the European Union, including Estonia, in a similar way to medicinal products," she said.

Not all homeopathic products can be sold in pharmacies; they need marketing authorization. As Estonia has no homeopathic tradition, just a few producers have requested for marketing authorization and only 14 medicines have it, Saaremäel said.

According to her social media post, the mother was using homeopathic preparations for the dehydrated toddler, which the Medicines Agency representative said do not have a marketing authorization in Estonia and have not been approved by a doctor or professional association.

Thus, Saaremäel continued they had been obtained elsewhere, and restricting the sale of homeopathic remedies in pharmacies would not solve the problem.

Joller: Homeopathic remedies should not be called medicines

Karmen Joller, a family doctor and member of the Reform Party parliamentary group in the Riigikogu, believes that homeopathic remedies should not be sold in pharmacies and intends to take up the issue in the Riigikogu. Joller pointed out that she has also contacted the Medicines Agency in the past on this issue and received the reply that since homeopathic products are registered with the European Medicines Agency, they should be registered with in Estonia.

"I am not a lawyer, so I am not sure how this works in law, but I've started looking into whether something can be changed in the situation," she said.

According to Joller, calling homeopathic preparations medicines is incorrect because they do not treat anything and, at best, contain a trace of an active substance. However, even if they are no longer available in Estonian pharmacies, it will only be a modest step forward in the fight against misinformation.

"In fact, the problem is much bigger than that," said the doctor, a parliamentarian who recently finished a US misinformation training course. "The dissemination of misinformation must be addressed more methodically. I and my fellow thinkers have some ideas we are implementing and will discuss in public at some point, but it's too early to say when."

According to Joller, several doctors recommend such remedies. The patient should be notified that it is a non-prescription drug, and the "family doctor" label on the door should be replaced with a more appropriate title.

The health authority does not monitor doctors' social media posts. Imre Kaas, head of communications at the agency, said they can disseminate evidence-based information and education, even if it includes refuting a doctor's post or a public member's promotion of malpractice. Any practice that harms people's health should be called out, Kaas said.

"A person's health can be harmed if they are misled and fail to receive evidence-based treatment," she said.

The health authority being cautious when a new miracle cure that instantly cures all diseases is promoted; however, Kaas agreed that maintaining a critical mindset can be difficult when unproven treatments are promoted by physicians themselves.

Homeopathy intertwined with conventional medicine in Germany

"Homeopathy has come from Germany, where it is intertwined with conventional medicine, and homeopaths also have some kind of registration, which gives the impression that it is a credible thing. The state subsidizes it and there was a discussion to put an end to it, but where they have got to I don't know," Joller said.

She said that Germany is leading the way in homeopathy and Estonia could set an example by saying that it does not have to be on the same level as conventional medicine, which has research behind it and proof.

In addition to homeopathic treatments, pharmacies sell various goods with unproven effects and inadequate trials. Joller cited red rice pills as an example of a medicine that should not be termed a food supplement.

No substance is a medicine if it doesn't work better than faith, she went on to say. "Why pay for homeopathic remedies when we could help a dog shelter, Ukrainian military, or fraudsters?"

The European Union Directive and the Estonian Medicinal Products Act define a homeopathic treatment as a product that has been manufactured in accordance with European official rules from homeopathic raw materials and bears the indication "Homeopathic remedy" on its packaging.

There are no specific instructions for these kinds of goods on the packaging or in the package leaflet. In the same way, homeopathic goods often don't say what they are on the package or in the leaflet that comes with it.

According to the Medicines Agency, such products therefore can be distinguished from other medications and should be administered under the supervision of a physician with specialized training.


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Editor: Karin Koppel, Kristina Kersa

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