Institute of Medicine Report Recommends Stricter Regulation of Alternative Medicine
The Institute of Medicine on Wednesday released "wide-ranging" recommendations to improve the regulation of dietary supplements and other alternative medicines in "an effort to help Americans sort through the mishmash of nontraditional therapies, some of which have potential benefits and some of which are sketchy at best," the Wall Street Journal reports (Petersen, Wall Street Journal, 1/13). The report, which was funded by NIH and the Agency for Health Care Research and Quality, recommends that alternative therapies be held to the same quality standards as conventional medicines (Elias, USA Today, 1/13).
The 330-page report stated, "Product reliability is low" (Bor, Baltimore Sun, 1/13). According to the report, more than one-third of U.S. residents have tried some form of alternative medicine, which refers to therapies ranging from prayer for one's own health to homeopathic products and chiropractic care (Wall Street Journal, 1/13). While overall use of alternative therapies has remained consistent for the past 14 years, the use of herbal products increased by 50% from 1997 to 2002 (USA Today, 1/13).
According to a 1994 law, vitamins and herbs are classified by FDA as foods, exempting marketers from having to provide information about side effects, health risks and proven efficacy (Baltimore Sun, 1/13). The report states that laws should be strengthened to further emphasize quality control and consumer protection (USA Today, 1/13). According to the Journal, it is "unclear which, if any, of the recommendations will ultimately be acted upon"; IOM will not be responsible for implementing any policy changes, and the report did not include predicted costs for the recommendations (Wall Street Journal, 1/13).
Mark Blumenthal of the not-for-profit American Botanical Council said that FDA cannot take on the added responsibilities IOM is recommending because the agency "lack[s] the manpower, the expertise and the budget to deal with herbal safety issues" (USA Today, 1/13).
IOM 's recommendations regarding dietary supplements include calls for "manufacturing principles" to be implemented to include quality; stricter labeling requirements; increased enforcement of rules against misleading health claims; and government investments in more alternative therapy research, including the creation of specialized research centers at NIH and other government agencies. Stuart Bondurant, executive dean of the Georgetown University Medical Center and chair of the committee that wrote the report, said, "Complementary and alternative medicine use is widespread and here to stay. We need to enable health care providers to provide comprehensive care" (Wall Street Journal, 1/13). Bondurant added, "The same rules should apply ... regardless of (a treatment's) origin and whether it is conventional or alternative medicine" (Baltimore Sun, 1/13).
Critics of alternative medicine "slapped" IOM for "being too coddling" to the industry, the Journal reports. Stephen Barrett, vice president of the National Council Against Health Fraud, said, "The report makes broad, sweeping generalizations and attempts to set an agenda for widespread adoption of study and teaching" (Wall Street Journal, 1/13). Barrett noted that the panel's members included advocates of alternative medicine who would benefit financially from more research funds, adding, "They gave an overly rosy view of this" (USA Today, 1/13).