On July 21, Britain’s government health system (the NHS) announced plans to stop doctors prescribing homeopathic, herbal and other “low value” treatments.
Simon Steven, the NHS England chief executive, described homeopathy as “at best a placebo and a misuse of scarce NHS funds”.
Strange how the term ‘placebo’ is always used in a derogatory fashion in reference to homeopathy. This point of view takes it for granted that millions of people over decades have been fooled by the homeopathic treatments they took. They didn’t really feel better or get better; they just kept going back to their homeopathic doctor or naturopath to spend money needlessly.
They must all be idiots.
And this while the drug industry is well aware that most of its products are ineffective in most patients.
In 2003 a senior executive with Britain’s biggest drug company admitted that most prescription medicines do not work on most people who take them. Allen Roses, at the time vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them the Independent reported at the time.
“The vast majority of drugs – more than 90 percent – only work in 30 or 50 percent of the people,” Dr Roses said. “I wouldn’t say that most drugs don’t work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don’t work in everybody.”
Most drugs work in fewer than one in two patients mainly because the recipients carry genes that interfere in some way with the medicine, he said.
He is not the only medical professional to admit that a specific drug is not going to help all people with the same condition. Dr. Jonathan St. George, assistant professor of emergency medicine at Weill Cornell Medical College told Men’s Journal: “But most chronic diseases involve a complex chain of biochemical interactions. The idea that you’re going to take one drug that affects one pathway and dramatically change the course of the illness is just pie in the sky.
“But if I told my patients that the drug I was prescribing them had only a 20 percent chance of working,” St. George says, “they’d look at me like I was crazy.”
There is a statistical measure to determine the chances of a drug being effective: the NNT, or “number needed to treat” – that is, the number of people who have to take a drug in order for one person to benefit. If a drug has an NNT of two, two people have to take it for one to benefit. Very few drugs have such a spectacular NNT.
You can look up the NNT of various treatments at thennt.com
According to thennt.com taking aspirin daily for one year, for healthy people: NNT to prevent one stroke or heart attack is 1,667; for people with a prior heart attack NNT = 77 to prevent one heart attack and NNT = 200 to prevent one stroke.
For people with a prior heart attack: NNT 77 to prevent one heart attack, 200 to prevent one stroke.
A medicine or treatment can have one of three effects: they can be beneficial, harmful or leave the condition unaffected.
In the case of homeopathic medications, it is well-known that they have no harmful effects while many allopathic medicines can have serious side effects. This is one of the main reasons for the continued popularity of homeopathy as a treatment of choice.
As for the placebo effect. It seems to be at work in both allopathic medicine and homeopathy and probably all manner of treatments. If the placebo effect is about patients partly believing that they will get better from what the doctor is prescribing, then it applies to both disciplines since some people benefit and some people don’t and that outcome applies to all kinds of treatments and medications, not just homeopathy.