MONTREAL (PasseportSanté.net) June 13, 2005 – “Are pharmacists in Quebec who sell natural health products going against their code of ethics? This is the powerful question asked by Jean-François Bussières, head of the Pharmacy Department at Sainte-Justine Hospital1 of Montreal, on the occasion of a recent conference entitled New rules of the game – Natural health products2.
Without giving a definitive answer to this question, Mr. Bussières raised several points that deserve reflection, both on the part of pharmacists, industry and consumers. Here are a few.
The crucial question of training
According to the code of ethics of the Ordre des pharmaciens du Québec (OPQ), “pharmacists must use their professional knowledge to defend and promote public health” and “keep their knowledge up to date and perfect”. “However, the reality,” said Mr. Bussières, “is that the University of Montreal has, in its program, only two compulsory courses on natural health products (NHP), and that at the University Laval, the two courses offered are optional. “
“If the pharmacist is satisfied with that, he may not have much to say to his customers,” he continued. In addition, if he is going to seek additional training, he must be vigilant and ensure that it is independent. This is a big challenge, according to Mr. Bussières, who believes that the NHP industry, when organizing training activities, must avoid falling into the trap of confusing the truly independent expert and the one who is paid. by industry, a confusion already too often present in the field of the industry of conventional drugs.
Evidence please
“The pharmacist must practice his profession according to current professional standards and current scientific data”, stipulates the code of ethics. According to Mr. Bussières, it is not easy to apply for NHPs: “If I want to provide the patient with information with integrity and there is no convincing data, I have scientific doubt and a intellectual conflict. To solve this problem, one can, for example, consult databases and systematic reviews, such as those produced by The Cochrane Library.3. Although they are still scarce, scientific data on NHPs do exist and, when we consult the Cochrane review on echinacea for example4, we realize that we can no longer say that it is “junk”. However, we must remain vigilant: some of the studies on this plant are well done, others show weaknesses. Can we offer NHPs without evidence? No ”, clearly stated Mr. Bussières.
False representation?
Still according to the code of ethics, “a pharmacist (…) must avoid, in his advertising, any allegation likely to suggest therapeutic properties which are not based on current scientific data. (…) A pharmacist (…) cannot, in his advertising, promote the consumption of drugs ”. Faced with this, Mr. Bussières wonders: “Do these provisions apply to NHPs? If so, are PSN’s advertising in pharmacy chain flyers acceptable? “
“By selling NHPs, even having displays that showcase them, the pharmacist is promoting them. He uses his credibility to tell the patient: “if I sell it in my pharmacy, it must look good”. If the pharmacist does not believe in the therapeutic virtues of these products, is he misrepresenting them? Mr. Bussières also wondered.
Products like no other
“The objective of the NHP industry, like that of the conventional drug industry, is to sell, to obtain a short-term return, and that is legitimate,” Bussières said. But, not all of these products are ordinary consumer goods. They exist to treat vulnerable, sick patients. By dialoguing, by asking the right questions, it is quite possible to find how to make the NHP market a prosperous commercial niche for the industry, but also compatible with the laws and regulations that govern practice and ethics. health professionals, ”concluded Mr. Bussières after a very lively presentation.
Françoise Ruby – PasseportSanté.net
1. Jean-François Bussières is also assistant clinical professor at the Faculty of Pharmacy at the University of Montreal.
2. This colloquium, organized by Insight, took place in Montreal on June 6 and 7, 2005 and brought together Quebec speakers from several sectors: the NHP industry, medicine and pharmacy, researchers, and consumer protection. Insight organizes conferences for businesses on economic, legal and regulatory issues.
3. Cochrane Library www.update-software.com
4. Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing and treating the common cold (Cochrane Review) www.update-software.com
