Cough medicine, homeopathy and many nutritional supplements: a "waste of money"

A huge number of over-the-counter medicines are a waste of money, including cough medicines and homeopathy, according to Anthony Cox, a clinical pharmacy lecturer at Birmingham University.

He argued in the Pharmaceutical Journal that community pharmacists should stop selling over-the-counter medicines with little evidence of working, as they are endorsing 'quackery'.

He said that pharmacists were being driven by the desire to provide what people are asking for - rather than taking into account that some of these products offer little or no benefit. He drew on a 2012 Which? report which found pharmacists selling "sub-therapeutic doses of drugs, dubious herbal slimming tablets, oils that allegedly reduce scarring and some highly implausible alternative remedies."

Homeopathy

He split the products found in pharmacies into three categories. The first he said: "would look more at home at a magic fair" including homeopathy, electronic machines to improve circulation and many nutritional supplements. He added: "These products undermine the scientific credibility of pharmacists."

Homeopathy has long been lambasted for failing to prove its scientific basis. A 2010 House of Commons Science and Technology Committee report on homeopathy said that remedies perform no better than placebos, and that the principles on which it is based are "scientifically implausible". Chief Medical Officer, Professor Dame Sally Davies, endorses this view.

Supplements

Nutritional supplements have also come under fire. A study by the University of Warwick and the Johns Hopkins School of Medicine in Baltimore, published in the Annals of Internal Medicine, indicated that they could be a waste of money.

It found that studies involving 450,000 people suggested that "supplementing the diet of well-nourished adults ... has no clear benefit and might even be harmful." The NHS takes the view that women hoping to conceive should take folic acid and the elderly and children under five can benefit from vitamin D. Other than that a balanced diet provides all the vitamins we need.

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Cough Medicine

The second group of products identified by Cox had a basis in science, but lack evidence of effectiveness, and include couch medicines based on mechanistic explanations of potential effects rather than outcomes from randomised controlled trials. He added: "Systematic reviews of cough medicines slow a lack of effectiveness." He said if these are stocked, pharmacists need to be clear about the lack of evidence of effectiveness.
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Given that we spend £444 million on cough medicines every year, this could come as a shock to the one in five people who come down with a cough each winter. However, as we reported last month, he is not the first to point out the problem with cough medicines. Dr Tim Ballard, vice chair of the Royal College of General Practitioners, says: "The medical evidence behind cough medicines is weak and there is no evidence to say that they will reduce the duration of illnesses – as such, GPs are unlikely to prescribe them."

Finally, there are over-the-counter medicines for which there is clear evidence of effectiveness, which he said: "can be sold with confidence." These include painkillers, antifungal creams and chloramphenicol eye drops.

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