‘No approved therapeutic claims’

While everybody was busy with the fanfare of Philippine elections, the Department of Health issued an administrative order requiring manufacturers and distributors of health supplements to “make it clear to buyers that the products are not to be considered medicines.”

What products? You have vitamins, weight-loss products, beauty aids, immune system and blood circulation boosters, whiteners, sexual performance enhancers and cure-alls that are supposedly effective for all sorts of problems—from allergies, indigestion, rheumatism, heart ailments, diabetes to cancer. Among others.

The perfunctory and vague phrase “No approved therapeutic claims” on the labels of health supplements, which nobody likely notices and takes seriously, should now read: “Important notice: The product is not medicine and is not to be used for treating diseases.” Translated into Filipino: “Mahalagang paalaala: Ang (name of product) ay hindi dapat gamiting panggamot sa anumang uri ng sakit.” And, for good measure, “Wastong nutrisyon at regular na ehersisyo ang pinakamainam na pagpapanatili ng kalusugan (Proper nutrition and regular exercise are still the best ways to ensure overall health.)”

The crackdown on health supplements began when Health Secretary Esperanza Cabral cited National Health Account statistics that said Filipinos spend P150 billion on health supplements and half of that amount is spent on products with no proven curative effects. Supplements may not, per se, be dangerous to one’s health. They may not necessarily be bad, but if on the other hand they don’t do any good, either, why should anybody spend good money on them?

Cabral believes that Filipinos are misled by some of these supplements’ aggressive advertising, especially when movie stars endorse them. Gullible consumers entertain the hope that at the very least, such supplements will prevent them from suffering from one disease or another. In the meantime, yet newer brands appear by the day, get introduced to Filipinos through ingenious marketing schemes and make billionaires out of businessmen. That’s good old capitalism at work.

In a radio interview several weeks ago, Cabral said that the government looks at the safety rather than the efficacy of these supplements. So unless there’s been a death or adverse side effects linked to a particular product, Cabral’s office is really powerless to stop the thriving business of these supplements. The only thing the Health Department can do is to get these businessmen to present their disclaimers in bolder, more comprehensible from so that the pubic can make better decisions.

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Mr. J., who has been distributing health products for years via multi-level marketing, thinks the big pharmaceutical companies are just exerting pressure on the government. “Big Pharma see supplements as a big threat so they use political and financial clout to get these unfair and unfounded warnings out.”

Mr. J., who has distributed malunggay, antioxidants, stem cell enhancers, inoulin fibers, and cardio supplements, wonders on what clinical study the government bases its claim. ”There is no empirical evidence that somebody died because the supplement’s promise was not fulfilled… there have been no studies to prove the uselessness of these products. Maybe they have anecdotal reports. It’s untrue, illogical and unfair.”

He has no problems introducing the new phraseology in Filipino on the labels of his goods. “Whether it’s English, Tagalog or German, it does not make a difference. We have never told our buyers that our products were medicines. The fact is, many medical doctors in the United States prescribe food supplements to their patients.”

A local doctor, Dr. H—a family medicine consultant to one of the leading health maintenance organizations in the country— says she does not prescribe supplements to her patients. “But if they ask me, I usually say multivitamins or ascorbic acid is okay. I take multivitamins myself when I miss my vegetables on a given day.”

This is not to say that Dr. H is a closet disciple of the merits of supplements, especially since other doctors are vehemently against using any form of supplement. “I am very careful. I tell my patients that supplements are not substitutes for nutritious food or the real medicine they should be taking.” And have her patients gone back to her, telling her of marked improvement in their condition? “Well, yes,” she admits. “Though the improvement may be psychological.”

Since a lot of the action apparently goes on in the mind, Dr. H allows for a “rational use” of supplements if the patient so desires it. It’s their money, anyway. But there must be no false expectations. Supplements are not replacements of medicines, and it is every doctor’s duty to make sure his or her patient knows the difference.

Unfortunately, not everybody is discerning enough to appreciate that drugs and supplements are two different things. It does not help that they are enticed to consume the latter over the former because it is more affordable, more popular, more profitable (especially if they get commissions from goading other people to buy it, too). It helps if a matinee idol endorses the product. What a stark departure from clinical prescriptions!

It is also glaring to note that while Mr. J is quick to dismiss the government’s anecdotal proofs of the supplements’ uselessness, some distributors resort to anecdotal proofs —otherwise known as testimonials—to convince people to buy their product. True, they don’t tell people that supplements are medicines. But they also don’t tell them that supplements are NOT medicines. That job now falls on the DOH-prescribed disclaimers, assuming people notice them in the first place.

It’s good to be health conscious, and it’s good that there are many choices available so that people can be more deliberate about the things they spend their money on. Still, desperation for a cure from an ailment, for relief from symptoms and for a preventive measure should not cloud one’s decision-making process. Bad judgment has only one cure—information. –Adelle Chua, Manila Standard Today

adellechua@gmail.com