The ASA Versus Homeopathy

The Advertising Standards Authority has produced a tough and comprehensive ruling about adverts for homeopathy, largely due to the number of complaints it has received about them.

It’s a long document, which you can read in full here. The gist of it is this: ‘We told the Society of Homeopaths not to discourage essential treatment for conditions for which medical supervision should be sought, including offering specific advice on or treatment for such conditions. We also told them not to make health claims for homeopathy unless they held sufficiently robust evidence of efficacy.’

One of its main concerns is that vulnerable people are being targeted; the web site for the Society of Homeopaths talks about conditions for which conventional medicine doesn’t help, for example. It’s not targeting people who are well but those who are already suffering and sometimes desperate, offering them hope, claiming that homeopathy ‘can be considered in almost any ill health’.

These may seem like weasel words – ‘can be considered’ seems vague enough to be a get out of jail free card – but more detailed claims are made.

The ASA was also concerned that there was no evidence that ‘treatment would be conducted under the supervision of a suitably qualified health professional’. In other words, homeopaths are not ‘qualified health professionals’.

The website claims that ‘There is a growing body of research evidence suggesting that treatment by a homeopath is clinically effective, cost effective and safe. … Currently, there is sufficient research evidence to support the use of homeopathic treatment for the following medical conditions: Allergies and upper respiratory tract infections, Ankle sprain, Bronchitis, Childhood diarrhoea, Chronic fatigue, Ear infections, Fibromyalgia, Hay fever, Influenza, Osteoarthritis, Premenstrual syndrome, Rheumatic diseases, Sinusitis, Vertigo’.

The ASA’s third main concern was about this evidence, that it does not in fact prove that homeopathy works any better than a placebo. The body of the ruling focuses on this aspect and looks at claims made for evidence in treating specific illnesses.

The ASA also looked at the Society's Twitter page, specifically: 'Antidepressant prescriptions up by 43 per cent. For more holistic healthcare which doesn’t rely on drugs try #homeopathy' and linked to the Society's website.

The ASA’s challenge was that
1. ad (a) could discourage essential treatment for depression, a medical condition for which medical supervision should be sought, and misleadingly implied that homeopathic remedies could alleviate symptoms of depression;
2. ad (b) could discourage essential treatment for conditions for which medical supervision should be sought; and
3. the claims in ad (b) that homeopathy could treat the following medical conditions were misleading and could not be substantiated. (my bold)

Regarding the claim about depression, the ASA ruled that
‘We considered that the reference to antidepressant prescriptions and the invitation to “try” homeopathy meant the ad was targeted at consumers with a pre-existing diagnosis of depression, particularly those who had been prescribed antidepressants. We considered the average consumer targeted by the ad was therefore particularly vulnerable.’ (my bold)

This is not a case of caveat emptor. Vulnerable people do not generally have the time, resources or sometimes the ability to do thorough research for themselves. If people read the small print then very many companies would lose their customers - beauty products and financial products in particular rely on people not looking at the small print. But buying a moisturizer that claims to prevent ageing is not in the same league as buying an alleged treatment for a serious medical condition. There has to be solid evidence.

The ASA underlines that ‘the CAP Code required health claims to be backed by evidence, which would be assessed on the basis of the available scientific knowledge. … We considered that listing medical conditions in this way meant consumers would expect the advertisers to hold robust scientific evidence to support the use of homeopathy for the listed conditions.’ (my bold)

The ASA then looks at the evidence. It cites the House of Commons’ Science and Technology Committee investigation of 2009–10 into the government’s policies on the provision of homeopathy through the NHS and the licensing of homeopathic products by the Medicines and Healthcare products Regulatory Authority.

The Committee concluded that homeopathic products ‘were not efficacious because they produced effects no better than those of a placebo treatment. They went on to state that they did not believe further research into homeopathy was warranted because sufficient testing had already taken place and evidence showed that it was not efficacious’.

This is pretty clear – it doesn’t work and it will never work no matter how many trials are done.

The ASA then went further and got their own expert to look at research provided by the Society of Homeopaths to ‘prove’ their claims for the various conditions listed on the web site. Homeopaths often claim that testing by non-homeopaths is unfair, biased or fails to take into account the way homeopathy works. But this was evidence they provided themselves.

The ASA found that their expert's ‘overall opinion of the evidence presented by the Society of Homeopaths, and the general body of published scientific and clinical data, was that it was not convincing in terms of efficacy and it was unlikely to be generally accepted by the scientific community.’

In every case, the ‘evidence’ was either flawed, insufficient or unscientific.

Again – it doesn’t work.

For every treatment for a specific condition listed on the web site, the ASA ruled that ‘We therefore concluded the claim was misleading and had not been substantiated’.

This restrained language means the evidence is no evidence at all, homeopaths must not make claims they can’t back up and they must stop targeting vulnerable people.

This is not the end of homeopathy. The web site will no doubt change its wording, making it vaguer, more shifty. Homeopathy is big business and businesses never go under without a fight. There is always a loophole and there are always vulnerable people to make money out of.

The ASA is doing its best to close the loopholes but it can’t tackle claims without complaints. This is why it’s important to keep reporting dodgy adverts and web sites to them. The Nightingale Collaboration has a good guide on how to complain.

The ruling is a victory but the battle continues.