One wonders if pharmacists have given up on science-based medicine altogether.

I mean most of them already stock homeopathy and woo like ear candles and holographic wrist bands, a lot have in-residence naturopaths and iridologists. But now there’s yet another way to rip off consumers by selling them stuff they don’t need, this time when they’re trying to get a prescription filled*.

It has just been announced that the Pharmacy Guild and Blackmores have joined forces to upsell you Blackmores supplements when filling a prescription. It’s all explained in the video below but basically now when you go to a pharmacist to get a script, a computer programme will match your medication to a Blackmores product, then the pharmacist will attempt to upsell you, by saying you need it if you’re taking that medication.

What a sweet deal between the Pharmacy Guild – the organisation who essentially manage the business side of pharmacies – and what a great little earner for Blackmores. The only people who are in line to get ripped off in this partnership are the consumers who will likely get sold expensive and unnecessary supplements. As Dr Ginni says in the video below, it’s the equivalent of saying “do you want fries with that?”.

It pains me to think that pharmacists exploit their status as one of Australia’s most trusted professions by doing crap like this. Do they really care about their patients anymore or are they only interested in lining their back pockets?  (The previous statement was made in frustration. Thanks to @pakili1987 for pointing out that this will not translate into a boon for individual pharmacists. It’s a ruling made by the Guild and many of them fervently disagree with it).

And they’ve really picked their timing on this haven’t they. Are they hoping we wouldn’t remember the recent TGA audit of CAM which found ninety percent of complementary medicines didn’t comply with regulations? Out of 31 selected for random audit;

• 22 were found to have manufacturing and/or quality issues
• 20 medicines had labelling issues or breaches which may mislead consumers
• 14 did not have adequate evidence to substantiate claims made about the medicines

That so many products failed to even satisfy quality or manufacturing standards has led for calls by the TGA to label supplements with “untested”. And why not. Consumers have a right to know they’re buying something that probably does nothing and in some case may even be harmful.

According to The Age;

“Obtaining evidence of efficacy of listed complementary medicines has been a difficult issue,” the audit report said.

“While most products are safe, if often ineffective, Australian research last year identified 39 reports of adverse events associated with such products, including four deaths over the previous two years.”

“Official inaction on the efficacy issue has been blamed on the Government’s reluctance to pay for tighter policing of the remedies, but also on pressure from industry leaders, including, Marcus Blackmore who rejects the disclaimer idea.

ORLY.

As for the Pharmacy Guild, never mind that our products don’t comply with TGA rules for safety and manufacturing, let’s gets our white coated “trusted” friends to push ’em on consumers anyway! What the hey! BUY OUR SHIT!

Disgraceful.

I remember one of the first things I ever did when becoming an active skeptic was sit with Richard Saunders and write an open letter to the pharmacists of Australia asking them to stop selling quackery. That was three years ago and instead of things getting better they only seem to be getting worse.

Well done Pharmacy Guild of Australia for taking the piss out of consumers and bringing your “trusted” profession into disrepute again. Shame on you.

*BTW I am uncertain this is a brand new idea. I’ve certainly had pharmacy staff attempt to upsell me supplements when being prescribed antibiotics but it only happened once and it was a long time ago. I presume this new deal means the upsell will now be exclusively Blackmores – what I don’t know is if means it will be more common place.

QUICK UPDATE: From an article in Fairfax this morning.

“He said it was the first time the Guild’s computer system, which is used by about 70 per cent of members, would prompt pharmacists to discuss complementary medicines with patients. The system has been used to alert pharmacists to potential drug interactions or medication compliance issues.”

What a dirty money grabbing exercise this is. Worse than I previously thought.


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  • Diane

    Good to see them back down on this. It didn’t sit right with me that they would try to use the social pressure of a public setting to try to sell extra products to patients who just want the transaction to be over with as soon as possible. If the products are that good, then let the doctor suggest it to the patient in a private, relaxed setting, rather than having the pharmacist do it.

    And to any pharmacists reading this, you need to do something about the serious lack of privacy in your stores. Give us some cubicles and/or bag our pills out of sight.

  • Henk v

    I have enjoyed this wonderful opportunity given to me by the pharmacy guild to humble their staff even more on the sale of unscientific claims (who knows what is in the packaging if the manufacturer doesn’t know its claims to be false).
    .
    Blackmores bitter and Blackmores Blue (50’s), now there is 6 decades worth of scientific health claim behind these.
    .
    Outraged? Hardly..Ive been waiting for it..
    .
    Personally I prefer dutch tobacco and german beer for my credibilities sake.

  • AndyD

    Two pharmacies in our small regional city regularly advertise Blackmores and Brauer products (and I’ve even seen ear candles advertised) in our local paper. That does, perhaps unfortunately, tend to colour my judgement of pharmacists, or pharmarcies, in general.

  • Simon

    this reminds me – any pharmacist or sceptic should watch this. It starts slow but I guarantee you’ll love it by the end.

    http://www.youtube.com/watch?v=HhGuXCuDb1U

  • Pakili1987

    I too am a pharmacist and am doing my PhD and I have recently started giving lectures on critical thinking in generally but tying it to CAM claims.
    .
    This deal appals me and I do not think that it represents pharmacist’s views on medicines and QUM whatsoever.
    .
    Please if you feel opposed to this deal and have facebook “like” the following page: http://www.facebook.com/#!/pages/I-am-a-pharmacist-and-I-oppose-the-Guild-Blackmores-agreement/143930299036485?sk=wall
    .
    Hopefully we can get enough numbers so that it is obvious to the public that just because the Guild has made a deal with Blackmore’s does not mean that we were a) involved, b) endorse it.

  • Jane

    Pharmacists – tell them how angry you are. Boycott Blackmores. Send complaint letters to the Guild. Give the PSA strength in numbers. A letter that has been doing the rounds is attached below:
    .
    Dear Sir/Madam,

    .
    As a pharmacist, I am absolutely appalled and disappointed at the Pharmacy Guild of Australia’s recent deal with Blackmores. Does the Guild not care about the reputation of pharmacies or pharmacists? I imagine since I am not a pharmacy owner or Guild member, this letter will be completely ignored as unimportant. But for your information, since the news broke, I have already had several irate customers in my pharmacy telling me what they think of your deal, of Blackmores, and of pharmacists in general. I can also assure you that if anything, these prompts that will soon appear on my dispensing software, will be having the opposite effect on me and my colleagues. In fact I and many other pharmacists, will be boycotting all Blackmores products – be they the new range or otherwise.

    If nothing else, your recent grubby deal will result in increased membership to your more professional counterparts, the PSA, and possibly more sales for Blackmores’ competitors. And I ask you – how does this deal differentiate pharmacies from supermarkets exactly? how does this move contribute to your argument against deregulation? How does this not perpetuate the image of snake oil salesman? Why would you want to portray our wonderful profession as glorified shopkeepers instead of the valued and valuable health professionals that we are?
    .
    Shame on you. I and many other pharmacists are so embarrassed and incensed at your behaviour – if we weren’t anti-Guild before, we definitely are now.
    .
    Yours sincerely,

  • RMB

    Incidentaly, should my dispensing software prompt me to sell someone something, I can safetly assure you that if will have the reverse effect on me and many other pharmacists opposed to this ‘arrangement’.
    .
    I do understand the pressure pharmacy owners are under – it is bloody expesive to run a pharmacy (rent, wages, registration fees, etc) and profits are constantly going down. So this may explain why they stock these products when they know there is no evidence for the majority. Having said that I am also constantly amazed at the amount of doctors that recommend one CAM or another. But at the end of the day, if the product is in the pharmacy, it DOES NOT mean that the pharmacist endorses it’s use or it’s claims. We sell propular anti-wrinkle creams, but I don’t really believe any of them work. But people want them and they buy them, and if you don’t stock them they ask you to. The pharmacist does not embody or represent every product in the store for goodness sake! I and many others are all about the science, not the fluff.

  • RMB

    I am a pharmacist and all I can say is that I am abolutely appalled at the Pharmacy Guild. As others have said, please remember that the Guild represents PHARMACY OWNERS and NOT pharmacists. Most pharmacists are members of professional bodies such as the Pharmaceutical Society of Australia, which have come out in the media to condem this action by the Guild.
    .
    Yes pharmacies have homeopathic and complemetary products available. This does not mean we actually sell these products. I am constantly amazed though at some customers who swear by them. I guess my boss stocks them in the hope that he will capture these sales. I can assure you that I, and my collegues, HAVE NEVER recommended a homeopathic product, and I myself NEVER recommend CAM. I go so far as to tell people evidence is limited, and this includes for products like glucosamine and fish oil, which many swear by.
    .
    I resent that the Guild has caused pharmacists to be lumped together into such a negative light. I spend my day at work calling doctors who have prescribed medications or dosages that would make their patients sick or even kill them, or have prescribed doses that would not even treat the condition (e.g. subtherapeutic doses of antibiotics, etc). I spend my time discussing drug interactions with doctors and patients, and I spend time discouraging patients from overdosing on their pain meds/over-the-counter meds etc. I explain to safety net customers that they shouldn’t stock up on their free meds because it is a waste of tax payers money, and I help people who come in with minor ailments or refer those with serious ones. THIS is what I and most other pharmacists spend out day doing. Yes there are bad pharmacists, just like there are bad doctors, teachers, nurses, etc. The majority are great at their job and really care about their patients, and are not just in it to make money.
    .
    Dont tar us all with the same negative Guild-coloured brush please.

  • Myk

    I think their selling of homeopathy and other products with insufficient evidence of efficacy says more about their unprofessional conduct.

  • Wazza

    If you have experienced unsolicited product selling find another pharmacy / pharmacist, and Marcus Blackmore should find a new CEO.

  • Evan Castle

    Here in the small town where I live, population ~15,000, there are three pharmacies. All three have Blackmores covering one wall. Nearly every bottle of snake-oil includes the words “DIETARY SUPPLEMENT” in small writing under the actual name of the product. Subtle enough that I only noticed it after reading the label of about 4 bottles.
    Why can’t they be made to replace that text with large eye-catching “FOOD. THAT’S ABOUT ALL THIS IS. FOOD. NOTHING MORE”?! Vultures.

  • Here’s the press release from the PSA:
    .

    Pharmaceutical Society of Australia
    NEWS RELEASE
    28 September 2011
    .

    PSA TO MEET BLACKMORES
    .

    The National President of the Pharmaceutical Society of Australia, Grant Kardachi, is meeting Blackmores this week and will seek an apology for the damaging and denigrating comments made about the profession of pharmacy.
    .

    Mr Kardachi said the “coke and fries” comment by Blackmores Chief Executive was more than unfortunate and ill-considered.
    .

    “The great danger of a flippant comment like this is that it has the potential to make consumers question the professionalism, skills and commitment of pharmacists. This in turn could lead to a reluctance on the part of consumers to accept the advice of pharmacists, gained over years of training and experience,” Mr Kardachi said.
    .

    “The end result could be adverse health impacts for the consumer.
    .

    “As our revised Code of Ethics, to be released next week, clearly states, „A pharmacist recognises the health and wellbeing of the consumer as their first priority.? This has always been the case and product will always be secondary to consumer wellbeing. Consumer health is our priority.”
    .

    Mr Kardachi said the new Code of Ethics also listed among its principles that “a pharmacist upholds the reputation and public trust of the profession” and “a pharmacist agrees to practise only under conditions which uphold the professional independence, judgement and integrity of themselves or others.”
    .

    Pharmacists are:
    • Health-care clinicians
    • Among the most trusted of all health-care professionals
    • Focussed on positive health outcomes for consumers
    • Committed to working with consumers on an individual basis to meet their individual needs and circumstances
    •Committed at all times to making their own independent decisions based on evidence
    .

    He said PSA, as the professional organisation representing all pharmacists, was working to try to contain the damage to the image of pharmacists from Blackmores comments.
    .

    “As the professional body, PSA has not been involved in this commercial agreement struck by the Guild and Blackmores, and are aware only of the details made public. However, PSA believes medicines and services are not ordinary items of commerce and cannot be treated as such. PSA does not support the Guild-Blackmores program.
    .

    “We are the custodians of the professional interests of pharmacists and as such, are responsible for ensuring the integrity and professional conduct of pharmacists who we are confident that being the processionals they are will continue to put the consumer first.
    .

    “We believe that pharmacists at all times act in the best interests of consumers and do not act with commercial gain as the primary motive. Our Code of Ethics makes this clear.”

  • Simon

    Bear in mind its not the pharmacists that have done this deal its the pharmacy owners guild. Please don’t take your anger out on pharmacists.

    http://www.apesma.com.au/article/?id=1408

  • Scott

    The guild is wrong to do this deal. It makes every pharmacist look like an up sellers. The PSA is right pharmacist should only sell recommend evidence based medicine. What is good about the deal is all the bad PR might make pharmacist re think before selling or recommending stuff that has no evidence behind it. Maybe pharmacist will stop employing other so called professions that ad path to their name to give it some degree of respect. Pharmacies have and always sold these dodgy products, which is fine if the right advice comes with it, that is balanced non biased and educated. I have and still sell vitamins and a few homeopathic in my pharmacy because there is a market and people believe they help. But if people ask for my advise or recommendation I will tell them that there is no evidence that they work I will recommend and give them option that are proven and still if the want the non proven treatment make sure it’s safe for them. This is usually when today tonight has found a new cure!

  • Mick Vagg

    I agree John

    the point-of-sale bit is where it becomes unethical. This allows Blackmores to do an end run around all the evidence and regulatory requirements and simply upsell once you get the concumer by themselves with an authority figure who is being prompted to increase their own cut of the sale.

    It is utterly unethical.

  • I think one of the primary objections is the way these products are being promoted at point-of-sale. Why the need for this unholy alliance between Blackmores and the Pharmacy Guild? Why not simply inform doctors and pharmacists of these products, and let them decide? Hell, no need to even go that far. You say that there is evidence for the efficacy of these products, so surely doctors and pharmacists would already have read the relevant studies in peer-reviewed medical journals, right?

  • 28 September 2011

    Marcus Blackmore responds to criticism on Blackmores, Pharmacy and the complementary medicine industry
    .

    An important program to support the healthcare of patients on some leading pharmaceutical drugs has ended up as an attack on complementary medicine and pharmacists.
    .

    The vitriol against pharmacy following our recent announcement of a
    pharmacy-only range of products to be recommended to people taking certain pharmaceutical drugs has been undeserved.

    Likewise the inference that complementary medicines are not evidence-based, safe or important to general health is fundamentally incorrect.
    .

    There are 10,000 listed complementary medicines in Australia and millions of these are sold every year predominantly in pharmacies where customers can receive well-informed advice.
    .

    We have intelligent consumers with an inalienable right to choose how they manage their health. Two in three households in Australia use complementarymedicines regularly, a practice that has been happening for decades.
    .

    Consumers are well-protected by one of the strictest regulatory systems in the world under which every manufacturer must hold the evidence to support the claims they make.
    .

    The Companions range is four products that are backed by scientific evidence and they have been developed in response to specific consumer needs. Any criticism of their potential benefit highlights the need for further healthcare professional education on medicine-related nutrient deficiencies.
    .

    There’s no intention for these products to interfere with the doctor’s prescription. The drugs will treat the disease, the supplements will address the nutrient deficiencies.
    .

    I am saddened to see people suggest that either Blackmores or the pharmacy profession would force these products on anyone who didn’t need them or that they would provide no benefit.
    .

    I’ve worked alongside the pharmacy profession for more than 50 years and, in my opinion, a pharmacist would only recommend a product to a customer if it were appropriate. No one wants to take any medicine that they don’t have a need for and this is against the philosophical values of Blackmores.
    .

    The fact is, pharmacists are extremely well-educated, accessible and highly ethical members of the community and they will use their expertise to determine when a recommendation for a product or further consultation with a health professional is required. The community needs prescription drugs and pharmacies provide a necessary distribution system for medicines. Pharmacy has become a destination for people seeking health advice and that, in my opinion, gives the pharmacist an important role.
    .

    Marcus C. Blackmore AM
    Chairman, Blackmores

    – ENDS –

  • Matt

    I have to say its really good to see APESMA getting stuck into the pharmacy guild about this.

    http://www.apesma.com.au/article/?id=1400
    http://www.apesma.com.au/article/?id=1408

  • Wazza

    Pharmacists provide excellent service, they are not being served by Kos Sclavos (President Pharmacy Guild of Australia) or the Guild hierarchy. I suggest all pharmcists call for change and proper representation before iy is too late. “The Genie is coming out of the bottle”

  • Trevor

    Whether or not “pop ups” on the screen influences actually practice may not be the only issue. The fact that the agreement exists does two things: It legitimises the use of alternative “medicines” and it also favours/legitimises one brand over another and does both of these with insubstantial evidence.
    .

    Perhaps “BPharm” would also like to recall the anecoctal evidence of the women that they were UNABLE to become pregnant with the use of “CAM.” That is why trials and evidence are used; the negatives are also included in the count!!
    .
    Also, when your refer to “the drugs that are unlikely to be any more effective anyway (esp antibiotics” I hope that you are not referring to instances of cellulitis or bacterial sinusitis…my anecdoctal evidence of the only times that I have been prescribed antibiotics!!

  • jeremy

    “BPharm” you worry me. My dad was a pharmacist his whole life, and I never heard stuff like this come out of his mouth. I have a degree including biochemistry, which is a shadow of what you should know. Dad would occasionally make a placebo treatment for some old dear to stop them worrying. But he understood the difference between the “ethical” products he sold (regulated drugs) and the “non-ethicals” (potions and ungents).
    .
    Let’s be clear – NONE of the non-ethical “CAMS pharma” work to a level that justifies their cost on the basis of the research to hand. Full stop. If you don’t know that, do some continuing education and read the research – CAMS “clinical trials” are a JOKE, and not because they lack money (have you checked the turnover of the majors like Blackmores?). They don’t do the studies, because they know it’s a waste of money for them – negatives don’t market magic.
    .
    Please do the ethical thing and focus on selling the “useful” non-ethicals – bandaids, cosmetics, wart treatments, anti-fungals, sanitary prodcust, condoms etc. Sell food products – most of the pills are much better replaced with a fruit bar or a soy shake.

  • @BPharm, actually it’s a bit more complicated than that. You can get patents for many different aspects of a product or chemical. For example for the method of extraction, and even for a new way of using it. This was how Viagra was patented – it was already a drug in use for CVD but we then re-patented for a different use – erectile dysfunction.
    .
    So if CAM sponsors found a way to extract, let’s say, echinacea to make it super concentrated or more bioavailable they could patent this method. This would afford them the same rights and profits as Big Pharma currently get from patents.
    .
    Likewise if you found a condition benefited from supplementation with an amino acid already available on the shelf you could also patent this as a new use and voila.
    .

    Mainstream CAMS as you refer to them have either not made it because they don’t work or nobody has bothered to look at ways such as above to market them (or as I said before, they have and they’re now medicine). And BTW once you have your patented idea you can sell it to Big Pharma and they can take care of the pesky clinical trials.
    .
    When you say “drugs that are unlikely to be any more effective (than CAM)” what are you referring to? Cause I for one would prefer to get some antibiotics when I have an infection, than take some Bach Flowers and hope it goes away. Just sayin’
    .

  • BPharm

    The reason why CAM manufacturers do not conduct RCTs purely comes down to patents and costs. If a company can prove that a product works but every Tom, Dick and Harry can sell it where is the incentive to spend the millions of dollars on the trial? This is the only reason why many “mainstream” CAMs have not made the leap to the label of medicine. Big Pharma get 15 years of exclusivity to justify the costs of drug trials, CAM manufacturers get no such concessions. None of this means that CAMs don’t work but not all CAMs are the same, there are many substandard brands out there as there are most industries.
    .

    I can categorically say that there were no other factors other than the addition of CAMs in the examples I’ve given above. One is me, one is a close friend.
    .

    I can also categorically tell you that having pop ups on a screen will in no way influence whether or not we recommend a product and if we do, what brand it will be. We ignore all the ones we get now, why should this be any different? I only recommend products from reputable manufacturers who have best practice manufacturing facilities and have therapeutic levels of ingredients in their formulations. I also don’t recommend these routinely but only after thorough discussion with customers about their health requirements. Time and time again they come back to thank me for how much better they feel. I’m quite sure it is the CAMs doing their job but even if there is an element of placebo effect who wouldn’t pay $20-$30 to rid themselves of their ills and feel better?
    .

    I have no problem sleeping at night when recommending CAMs to my customers and feel it is a far more ethical approach in many instances than sending them off to docs for drugs that are unlikely to be any more effective anyway (esp antibiotics. My focus is always the ongoing health of the customer so how can I possibly be accused of unethical practice.

  • This just in from Australian Dr

    “But Mr Kardachi (Grant Kardachi, national president of the Pharmaceutical Society of Australia), in a statement today, said he was “appalled by any reference that pharmacies may become a McDonald’s style business”.
    .
    He described the “coke and fries quote” as “very unfortunate and has done great damage to the profession of pharmacy”.
    .
    The furore comes a week before the PSA launches its revised code of ethics for pharmacists.
    .
    Mr Kardachi said: “This code reinforces the principle that pharmacists should ensure that medicines and products they recommend are evidence-based and will have positive health outcomes for consumers.”

  • “Alternative” medicine which is scientifically, clinically demonstrated to have real usefulness and real efficacy as well as reasonable safety… then becomes actual medicine.
    .

    If there was legitimate scientific, clinical evidence that some sort of particular mineral supplement, for example, was responsible for improved patient outcomes, reduced adverse side effects, etc, specifically when co-administered with a particular prescription pharmaceutical, then that particular mineral would be added to the drug regimen prescribed by the physician, and it would probably be incorporated into the manufacturing of the actual tablets etc. of that pharmaceutical product.
    .

    If that genuine, credible clinical evidence basis does not actually exist, then this is just the latest in a long line of unfortunate examples of pharmacies abusing the community trust in pharmacists as purveyors of science-based, evidence-based medicine, and selling out to Big Quacka.

  • @BPharm. The plural of anecdotes is not evidence. The TGA will take your argument from antiquity but science doesn’t. Acupuncture has been around for ~ 300 years and it still doesn’t work. On the other hand, people used to chew willow bark for pain and now we know why. This is because science looked at both these questions and determined why and how they work/don’t work.
    .
    If I take echinacea today for a cold and then my cold gets better in 5 days can I say it was the echinacea? Well I can, but the natural course of disease is about 5 days, so my cold would have got better anyway. Just the same as any of your anecdotes cited above. Do you know there were no other interventions except the CAM? How can you be sure it was the supplement which resulted in the woman falling pregnant? This is why we do RCTs and then meta-analyses which are published as Cochrane reviews. So we can remove any biases, either from other interventions or our own interpretations. This is how we know the majority of CAMS do not work – and those that do are not alternative medicines anymore, they’re medicine.
    .
    You say I don’t know how the scheme works – sure I don’t work as a pharmacist so I only know what I’ve been told. Are you speaking as an independent pharmacist or someone who works for a big chain? Because from what I’ve been told, if you work for a chain and your head office decides to endorse this idea then you don’t get a choice whether you use it or not.
    .
    And if you use GuildCare won’t you be getting a pop-up reminder to recommend a Blackmores Companion product when filling a prescription? Even if you ignore it, there is evidence showing that this kind of exposure does influence people’s choices down the line. Just as having a Big Pharma pen on your desk influences your prescribing choices as a doctor.
    .
    Whether this scheme takes off or not I think the most disturbing thing is the issues of ethics. Is it ethical to take fifteen bucks off a customer for a supplement for which there is little to no evidence it will be beneficial? You don’t think that as one of Australia’s most trusted professions this is both exploitative of your position and that of a sick probably vulnerable customer? Do you think increasing the cost and medication burden for patients is a good idea?
    .
    Correct me if I’m wrong but I also thought selling products for which there is no evidence base was against your code of conduct.

  • BPharm

    Maggie, you do not understand what this “scheme” even is. It will not make one iota of difference to how pharmacists are currently practicing, there will just be one more range of products on the shelf (or not if you don’t even choose to stock them). Blackmores are trying to enhance their reputation by having a Gold Cross placed on their products. This will not necessarily result in more pharmacists selling them and there will be no onus on them to do so. Everyone is getting overly excited about nothing. Pharmacists will make their own decisions on what they sell and to whom, they will stock these products or not, they will talk to their customers or not. If Blackmores want to give money to Gold Cross for an endorsement more fool them, it guarantees them nothing because you’ll never force a pharmacist to do anything they are not comfortable doing. There isn’t even a story here.
    .

    And yes there is much evidence for CAMs it just depends where you look. Anecdotal evidence and 300 years of use will do just fine in many instances. CAM produces don’t have the money of big pharma to conduct double blind placebo controlled trials but that doesn’t mean they don’t work. I have seen ovarian cysts disappear, women get pregnant in 3 months after trying conventional methods for years, people who have been immobile due to pain get up and walk around the block, crippling migraines controlled and reduced. I don’t need a Cochrane Review to tell me these products worked where doctors and conventional medicine could not.

  • @BPharm, whilst it agree with most of your points I can’t agree with this

    “There is a significant body of evidence to demonstrate that complementary medicines can assist with these.”

    There really isn’t. There is some evidence for some CAM being beneficial for some conditions. For example, St John’s Wort does work for mild depression. Also supplements are beneficial when you are suffering from a deficiency. But otherwise they’re just made into expensive and colourful urine.
    .
    Yes there is a belief that CAM works but this doesn’t make it work. In Australia we don’t even know what is in a lot of it cause the labelling is either wrong or misleading and the sponsors are liberal with claims. A recent review of CAM L products found 90% didn’t even comply with the TGA regulations.
    .
    I agree that pharmacists are qualified to recommend supplements to customers when deemed necessary but this scheme is nothing more than a grab for cash. It seems the only outcome it will achieve is to increase the medication burden and cost to the most vulnerable.
    .
    I know there are good pharmacists who do a good job but their money grabbing Guild is not doing their reputation any favours.

  • BPharm

    Anybody who thinks a pill from the doctor is going to cure their chronic health conditions is fooling themselves. There are many other factors to consider including lifestyle factors, disease complications and drug adverse effects.
    .
    There is a significant body of evidence to demonstrate that complementary medicines can assist with these. More than 60% of Australians take complementary medicines so clearly there is a belief in their effectiveness. I have seen many, many examples of this and have no hesitation in recommending them to customers in appropriate circumstances after significant consultation. To suggest that doctors hold all the aces and are the only ones in a position to help their patients is ludicrous. In many instances they haven’t a clue what their patients are really up to. I’m not a big fan of the Blackmores deal (it is not exclusive by the way, it’s just another option that happens to carry a Gold Cross) and I will continue to source the most reputable products with the greatest body of evidence behind them for my recommendations. What I object to is being lumped with the tag of being a profiteer selling snake oil. I go to great lengths to improve the health outcomes of my customers and complementary medicines play a big role in that. I’ve seen their benefits over and over with my own two eyes. I also have a right to make profit, 5 years of training, 15 years of experience and countless positive health outcomes give me that right. My time you get for free, doctors charge $60 for 10 minutes, I still think I’m providing the better deal and you can talk to me any time, no waiting rooms. Don’t underestimate the expertise of your pharmacist, we are highly trained and we care. If you can’t say that about your pharmacist find another one, there are many excellent ones out there, and they hold all the aces to keeping you well.

  • Steve

    CoQ10 has no proven benefit for statin users. Statins are associated with a drop in circulating CoQ10 and this is claimed to cause muscle problems. The difficulty of this is that circulating CoQ10 is carried on the LDL cholesterol particles that statins reduce, and there is little if any evidence of effects on muscle tissue levels.
    .

    Also, there has never been a difference between statins & placebo for any muscle problems, subjective or objectively measured (e.g. measures of the muscle breakdown enzyme CK), in any double blind trial. Therefore taking CoQ10 is treating a “problem” that exists only as a type of placebo effect: people are told there is a link with statins & muscle problems, so believe they are experiencing them when taking these products.
    .

    One “study” of muscle problems was in patients with perceived muscle problems on statins including lovastatin. They were given red yeast rice, a traditional Chinese medicine. They had reduced cholesterol, although not as much as statins would produce, and no muscle problems. The only problem with this is that red yeast rice produces lovastatin in uncontrolled amounts. If lovastatin produced problems when being taken as a pill, why not when unknowingly taken in an alternative medicine?
    .

    The real problem with CoQ10 promotion is the concerns raised re statins can cause people who would benefit from this therapy (anyone who qualifies for statin therapy under the PBS guidelines) to stop using them.

  • Katrina Love

    If pharmacists want to recommend a non=prescription complementary supplement that may alleviate common known side effects of prescription medication, that is fine by me, but brand specific is definitely NOT OK… especially Blackmores which has rated so poorly on actual percentage of active ingredients in their supplements compared to what is specified on their labels. Blackmores brand is one of the last brands I would ever buy, in any class of supplement.

  • Alicia

    I can’t believe everyone thinks this is a new thing- sure we’ve not had brand specific suggestions before but for as long as I remember retail pharmacy has been about add-on sales! It’s pitched as selling a ‘health solution’ but it’s really about meeting those KPI’s- basket size rules all!!!

  • @Kae, someone else suggested this today too. What do Nature’s Own and other supplement manufacturers have to say about this stitched-up deal?

  • Lachlan

    While I’ll agree that it is wrong for the computing software to display only one brand of complimentary medicine, Pharmacists are much more aware than any other profession about these medicines, and will be honest with the patient. In Australia (on average), Pharmacy students spend more class hours in their four year course, then Doctors do in their six year course, and all their class time is completely specialized in order to understand the action effect and composition of medicines. Pharmacists know more than anyone about these products.
    .

    I think it is a disgusting thing for the Pharmacy Guild to do, but being a Pharmacist, I know that only those Pharmacist’s who believe the product might be beneficial for the patient will recommend them. People need to realize that Pharmacist’s do recommend these products already, when considered beneficial. Nothing will change apart from a computerised message, and if people realised how many messages are displayed when you dispense a medication, you will start to realise how benine this ordeal is.
    .

    M.Pharm

  • kae

    Isn’t it a breech of the competition laws for the chemist to recommend one brand over another of general, er, crap?

  • Jill

    There’s a privacy issue too if other customers are in earshot. We get precious little privacy in pharmacies as it is, they shouldn’t be making things even worse.

  • Sorry Thelma, I’m not really clear what you mean. You were prescribed statins but you didn’t take them – but you have first hand experience that statins damage muscle?
    .
    Why are you taking CoQ10 if you’re not taking statins? Why do you need CoQ if you’re not taking statins?

  • Thelma Pirie

    I am more disgusted bt the drug companies who peddle poisons and Doctors who aid and abet them. I was prescribed statins although my ch levels were ok, my doctor did say I should take coenzyme Q10 to counteract the affect of the stains on heart muscle. I have first hand knowledge that stains damage muscles. Although I only know four people who have taken statins and two have had severe muscle loss. I don’t take the statins but I do take lots of Coenzyme Q10.

  • Andrew

    It’s not the equivalent of saying “do you want fries with that?”, it’s the equivalent of saying “you should take fries with that”!

    As a pharmacist, I’m disgusted with this kind of deal.

  • How’s this for a doozy – the response from the Guild to the idea that supermarkets are allowed to have in-shop pharmacies
    .
    http://bit.ly/naZpit
    .

    Supermarkets should never be allowed to operate pharmacies
    .

    Pharmacists care about patients and health outcomes. Supermarkets are legally obligated to put shareholders and profit FIRST..
    .

    BWAHAHAHHA

  • Ken McLeod

    The Pharmacy Guild is rapidly becoming Australia’s biggest joke.

  • zzaardvark

    When is enough enough?
    .

    So the pharmacy cabal is now going to use their privileged position as the sole dispensers of prescription medicines to push market their long suffering customers products of questionable value manufactured by a single company to the exclusion of any competitor?
    .

    This is in addition to other questionable behaviours, such as using their store space to sell all manner of non health-related trash as well as their insistence on providing ‘specialist’ medication advice upon presentation of a prescription – surely the domain of the prescribing doctor.
    .

    It’s about time this consumer unfriendly situation was addressed. Either the role of pharmacy is specialised and its function carefully controlled, or it is not and should be available to any other type of hawker, be it supermarket, petrol station or corner store.

  • The addition of a seal of approval to the bottles is too much. While pharmacies in Canada have the same supplements available, I have never been recommended one by a pharmacist (I know, I know its only an anecdote). However, I have not looked for an endorsement by an authority. I will next time I am shopping. I hope we do not face the same issue; though it will give me a cause.