Interesting example of alternative-health marketing

[Darth Wong]

http://www.thirddayresources.com/

Notice how you can't, no matter where you look, find anything that even hints at what ingredients are actually contained in this wonder drug. This is actually a pretty good model for how alternative-health products are often marketed; heavy emphasis on the nature of the problems it's supposed to solve but almost no detail about the product itself.

[wilfulton]

Well in the 19th century wild wild west, you'd have peddlers going about selling various medical concoctions containing god knows what plus alochol and claim it'll cure any ailment.* Such shenanigans have made many people rich in the past, and I suspect they will continue making people rich well into the future.

It's a situation of caveat empor: let the buyer beware. Some herbal supplements may actually be beneficial, but it would really be stretching the truth to say they're miracle cures/wonder drugs. But as they say, there's a sucker born every minute.

* But at least one person had a little knowledge of such scandals. "Does it get rid of stains?" Asks the Outlaw Josey Wales after spitting tobacco juice on the guy's immaculate white suit.

[FSTargetDrone]

http://www.thirddayresources.com/

Notice how you can't, no matter where you look, find anything that even hints at what ingredients are actually contained in this wonder drug. This is actually a pretty good model for how alternative-health products are often marketed; heavy emphasis on the nature of the problems it's supposed to solve but almost no detail about the product itself.

The business on that page about "A faith-based company" stating it is, "A team knitted together by God." should be another warning sign. Any organization short of a purely religous one that offers medical treatments while taling about "faith-based" anything is not one to be taken seriously. But we all know this sort of thing appeals to a certain type.

And it's my understanding that there is next to no real enforcment of laws regarding any claims made by such companies by the FDA, at least in the U.S. Could you get away with this in Canada, or Europe?

[Darth Wong]

The business on that page about "A faith-based company" stating it is, "A team knitted together by God." should be another warning sign. Any organization short of a purely religous one that offers medical treatments while taling about "faith-based" anything is not one to be taken seriously. But we all know this sort of thing appeals to a certain type.

Indeed. Marketers of this sort of product would be unwise to court the scientifically savvy market sector.

And it's my understanding that there is next to no real enforcment of laws regarding any claims made by such companies by the FDA, at least in the U.S. Could you get away with this in Canada, or Europe?

Canada and Europe are starting to crack down on unsupported claims, but it's a tricky thing to do. At what point do you draw the line between folksy home remedies and pharmaceutical drugs? Will we ever get to the point that it's illegal to tell people that chicken soup is good for the common cold without peer-reviewed clinical studies which cost hundreds of millions of dollars to conduct (and which no one will therefore be willing to pay for unless there's a patent and big profits in store for them?)

[Metatwaddle]

The thing that always strikes me with these vacuous pages is that they can manage to write so many words and put them on a webpage and yet say absolutely nothing.

Of course, that strikes me about a lot of different things, like political pamphlets, so YMMV.

[FSTargetDrone]

Canada and Europe are starting to crack down on unsupported claims, but it's a tricky thing to do. At what point do you draw the line between folksy home remedies and pharmaceutical drugs? Will we ever get to the point that it's illegal to tell people that chicken soup is good for the common cold without peer-reviewed clinical studies which cost hundreds of millions of dollars to conduct (and which no one will therefore be willing to pay for unless there's a patent and big profits in store for them?)

And another problem with these herbal remedies, you cannot be sure that the product even contains what it claims to.

Also, did you notice the legalese?

The information given within these pages is designed to help you make informed decisions about your health. It is not intended as a substitute for the advice or treatment that may have been prescribed by your physician. Please remember that true health involves addressing all the systems of the body, and not just using one particular product as your hope for good health. Before adhering to any of the information or recommendations, you may want to consult with your personal health care professional. Understand that you are solely responsible for the way that this information is perceived and utilized, and do so at your own risk. In no way will Third Day Resources or Dr. Joseph Khoo be responsible for any injuries or problems that might occur due to the use of this web site, the advice contained within or the products offered. IF YOU HAVE QUESTIONS, PLEASE ASK YOUR HEALTH CARE PRACTITIONER!

These statements have not been reviewed by the FDA. Products are not intended to diagnose, treat, cure or prevent any disease.

(Emphasis mine.)

Essentially they are saying that nothing they sell can be trusted to do what they say it will! How many legitimate sellers of products that are clearly intended to be considered some sort of treatment for an ailment would have such a disclaimer? For example, I can find no such disclaimer on Bayer's Aspirin website (the first drug that came to mind). Rather, the Bayer site lists possible interactions with other drugs, and various warnings. The "Combetic" thing makes no warnings of the kind, as far as I can find, with regard to possible interactions.

A quick search reveals that this "Dr. Joseph Khoo" has made an interesting claim about his "Combetic" product:

We believe Combetic has the right combination of herbs to control blood sugar levels in diabetic patients. The essence of the herbs in Combetic is extracted by modern bioscience technology. It is completely herbal and contains no pharmaceutical drugs. There are no known drug interactions with Combetic. According to Dr. Joseph Khoo from Singapore, Chief Medical Consultant of Third Day Resources, "Combetic is a replacement and not supplementary therapy."

That last sentence sure sounds like a claim of medical effectiveness to me... Other than references to various discussion forums (many of which seem to have been copied and pasted!) and the thing above, there is little to learn about him.

[Winston Blake]

At least if you get to the end of their 'Research PDF' (which is more or less just wikipedia-level info on diabetes) you get some honesty:

Conclusion

Combetic is a highly effective herbal therapy to lower blood sugar level.

Disclaimer: These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

For more information please contact us at info@thirddayresources.com

Also:

Our goal is to stop all medications completely. However, there will be a portion of Type I
diabetics who continue to need insulin injections. We acknowledge this and will keep
these patients on insulin injections together with Combetic.

Gee, so i guess if it does nothing for you then you're a part of that portion on whom it's ineffective.

[Mange]

And it's my understanding that there is next to no real enforcment of laws regarding any claims made by such companies by the FDA, at least in the U.S. Could you get away with this in Canada, or Europe?

I don't know about the other countries in Europe (there are different laws in each country and there is an EU legislation as well), but here in Sweden, the Marketing Act states that all statements and promises about a product must be truthful (exaggerated statements and claims aren't allowed) and that the company making any claims about their product/s must be able to substantiate them.

For the specific issue of alternative health products, all alternative medicins etc. must be submitted to (full chemical and pharmaceutical documentation is required) and approved by the Swedish Medical Products Agency before they can be sold to consumers. When approved, the packaging must state that the product hasn't been tested in the same way as conventional medicinal products and the advertising can't say that the product lacks side effects.

[Broomstick]

And it's my understanding that there is next to no real enforcment of laws regarding any claims made by such companies by the FDA, at least in the U.S. Could you get away with this in Canada, or Europe?

There have been prosecutions in the US on unsubstatiated claims, and some things are either banned (comfrey intended to be taken internally) or might as well be after strong pressure to remove them from the market (kava kava, ephedra/ma huag). But companies hire clever lawyers to produce cover-your-ass ad copy and disclaimers, and the laws governing supplements hold them to standards less strict than drugs.

Will we ever get to the point that it's illegal to tell people that chicken soup is good for the common cold without peer-reviewed clinical studies which cost hundreds of millions of dollars to conduct (and which no one will therefore be willing to pay for unless there's a patent and big profits in store for them?)

Actually, someone did do a study on chicken soup, which was written up in one of the peer review journals (New England Journal of Medicine, if I recall, but that's strictly out of memory). Conclusion: soups do help the ill, providing fluid and electrolytes, and traditional chicken soup slightly outperformed other soups tested. However, it was just one study so no one has replicated the results.

(Really. Notice: no smiley face)

[wolveraptor]

People would only care about the chicken soup claim if advertisers tried to use it to hock their products. To my knowledge, no one really does.

[Admiral Valdemar]

As someone eyeing the prospect of being in medical and biotech sales, you simply wouldn't get away with this when selling to clients that are massive organisations like the NHS or private health firms. They demand you show empirical evidence of the drug or device you're selling in action and working as advertised. You have to disclose what's in the thing and how it works and only then can you get on to selling it to the GP or surgeon etc. If they have even the slightest doubt, then you can kiss the sale goodbye, because failure to buy a certified and safe product will ruin the career of the buyer, doubly so if it's an NHS trust.

And this is why you don't get such alternative medicines as standard. Too bad the Prince of Wales is pushing for more funding into such crap, just to appease those morons in society who do want this therapy as part of the health service.

[Rye]

It's worth noting though, that up until recently, like, less than the last 30 years or so my male parental figure has been in general practise, doctors have prescribed placeboes as an accompanyment to normal treatment because they do have a real effect. The trouble is, now more people know what "placebo" means, so they read the prescription and get pissed off, or look at the pills given and "calcium glutamate? how is that going to help me?" and might look it up on the net, then get pissed off when the GP is prescribing them spurious pills.

So that's why they're getting extra alternative medicine in the NHS, because placeboes DO work, they just have to change the method of delivery. Hopefully, they'll do this the sensible way, and just have convincing actors to shoots healing chi or whatever at people, and not have to spend as much on it as they would hiring an established faith healer.

[Beowulf]

Just remember, water hemlock and nightshade are all natural.

[Admiral Valdemar]

It's worth noting though, that up until recently, like, less than the last 30 years or so my male parental figure has been in general practise, doctors have prescribed placeboes as an accompanyment to normal treatment because they do have a real effect. The trouble is, now more people know what "placebo" means, so they read the prescription and get pissed off, or look at the pills given and "calcium glutamate? how is that going to help me?" and might look it up on the net, then get pissed off when the GP is prescribing them spurious pills.

So that's why they're getting extra alternative medicine in the NHS, because placeboes DO work, they just have to change the method of delivery. Hopefully, they'll do this the sensible way, and just have convincing actors to shoots healing chi or whatever at people, and not have to spend as much on it as they would hiring an established faith healer.

A placebo has very limited effects. You wouldn't for instance, prescribe them to someone with cancer that's metastasized. They do help, yes, but they are not cures and never will be. The effects of a placebo are generally on the mental state of the patient, helping to lower stress levels which can directly hamper immune defences, which is why stress from work is such a big medical problem in this hectic age. They have no major biochemical effect, and most every study I've read leads to little/no net result or inconclusive results.

So long as the money is still going en masse towards proper treatments and not squandered on pretty useless herbal remedies or vitamin tablets, then the NHS will serve its purpose well. Money is tight enough in the NHS without more people wanting more money on practically useless "natural" (whatever the hell that even means) remedies, when the money could go towards an fMRI or HAART programme. John Diamond's study of such alternative therapies when he was dying of terminal cancer is and interesting treatise on the harm these "medicines" can do to people by giving false hope.

[Darth Servo]

Will we ever get to the point that it's illegal to tell people that chicken soup is good for the common cold without peer-reviewed clinical studies which cost hundreds of millions of dollars to conduct (and which no one will therefore be willing to pay for unless there's a patent and big profits in store for them?)

Campbells just might be willing to fork out the cash.

[Rye]

A placebo has very limited effects. You wouldn't for instance, prescribe them to someone with cancer that's metastasized. They do help, yes, but they are not cures and never will be.

I'm not disagreeing with that, I'm just saying that they can be complimentary to normal treatment, in fact, they should be if they increase healing rates and reduce hypochondria, psychosomatic pains and so on.

Also, I wouldn't put all herbs into the placebo pile (which I don't think you were doing, but just in case). St John's Wort has been shown to be an effective antidepressant in mild to moderate depression (source), and of course you would expect them to have some that work, some that are indistinguishable from placebo and some that are detrimental.

[Admiral Valdemar]

That is certainly the case, and they should be used to help alleviate pain, especially if they are cheaper and less toxic. I believe St. John's Wort was one option my mum's GP prescribed her for depression after the Prozac prescription had been used up. As I've read elsewhere, a lot of the effect of anti-depressants seems to purely be placebo based, though neurology is a complex subject, to be sure.

What I don't get is the "natural remedy" movement, which is just as stupid as organic food. There is NO difference, yet, the quacks of that side seem to make it out like herbal remedies are the one true answer, and Big Pharma drugs are nasty and only make money. They cleverly forget that all modern drugs come from natural sources anyway and are only synthetic in that factories make the active ingredients en masse, rather than, say, ripping down the Amazon for one type of plant.

[Rye]

That is certainly the case, and they should be used to help alleviate pain, especially if they are cheaper and less toxic. I believe St. John's Wort was one option my mum's GP prescribed her for depression after the Prozac prescription had been used up. As I've read elsewhere, a lot of the effect of anti-depressants seems to purely be placebo based, though neurology is a complex subject, to be sure.

Uhm, what?

Look at the results/conclusion on the page I linked to: Results: Hypericum extracts were significantly superior to placebo (ratio = 2.67; 95% confidence interval 1.78 to 4.01) and similarly effective as standard antidepressants (single preparations 1.10; 0.93 to 1.31, combinations 1.52; 0.78 to 2.94). There were two (0.8%) drop outs for side effects with hypericum and seven (3.0%) with standard antidepressant drugs. Side effects occurred in 50 (19.8%) patients on hypericum and 84 (52.8%) patients on standard antidepressants.

Conclusion: There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders.

[Zero]

I know new-age things are almost always full of shit, but I have to admit, I don't see most advertisements actively explaining how something can be effective as a treatment, or showing off statistics or anything, and that page mainly is an advertisement.

For instance, searching the viagra site, I find little information on how exactly it might be effective, and no specific data, although it does say that the drug is sildenafil citrate, which is obviously better than the site at the top, and it actually has info on the troubles its meant to help with, so it isn't the same, I'm just pointing out that a lack of relevant data on the ad site might not be as important as you might expect.

http://www.viagra.com/index.asp

[Admiral Valdemar]

Uhm, what?

Look at the results/conclusion on the page I linked to: Results: Hypericum extracts were significantly superior to placebo (ratio = 2.67; 95% confidence interval 1.78 to 4.01) and similarly effective as standard antidepressants (single preparations 1.10; 0.93 to 1.31, combinations 1.52; 0.78 to 2.94). There were two (0.8%) drop outs for side effects with hypericum and seven (3.0%) with standard antidepressant drugs. Side effects occurred in 50 (19.8%) patients on hypericum and 84 (52.8%) patients on standard antidepressants.

Conclusion: There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders.

Firstly, I didn't say anything about hypericum in that context. I'm not talking about just one set of treatments either. A few studies (Khan, 2000, though can't find it online here) state that the placebo effect accounts for up to 70%+ of the treatment results, as opposed to a biochemical interaction from the treatment prescribed. Until we understand depression more than we do now, which should change thanks to modern fMRI systems, the placebo effect apparently works better than happy drugs targeting whatever section of the brain is in difficulty.

I also note that a fair few doctors today just came out and attacked any plans for the NHS to use any more of its limited resources on alternative medicines which could deny treatments that empirically work from being funded.

I think acupunture is the one therapy that seems to have a fair placebo effect or something else and is becoming more common. I do have a friend whose mother is a retired nurse and now has a homeopathy company. I had to speak my mind on that bullshit, and the girl went mental trying to defend the practice and her mother's choice. Frankly, an RGN should know better, unless she actively chose such a plan because it's easy to make money from gullible fools.

[AdmiralKanos]

Firstly, I didn't say anything about hypericum in that context. I'm not talking about just one set of treatments either. A few studies (Khan, 2000, though can't find it online here) state that the placebo effect accounts for up to 70%+ of the treatment results, as opposed to a biochemical interaction from the treatment prescribed. Until we understand depression more than we do now, which should change thanks to modern fMRI systems, the placebo effect apparently works better than happy drugs targeting whatever section of the brain is in difficulty.

Anti-depresssant drugs have been a major public-relations catastrophe for the pharmaceutical industry. Not only is there mounting evidence of their long-term ineffectiveness, but they have been linked to numerous bizarre incidents including mass-murders. This sort of thing gives rhetorical traction to anti-scientific religious zealots and Scientologists, since they tend to not differentiate between different branches or theories in science. As far as they're concerned, it's a monolithic entity, and bullshit from one scientist is bullshit from all scientists.

I also note that a fair few doctors today just came out and attacked any plans for the NHS to use any more of its limited resources on alternative medicines which could deny treatments that empirically work from being funded.

I too have serious misgivings about spending public money on anything that is not scientifically supportable, although it is also true that knee-jerk dismissal of all alternative-health treatments is premature (there have been various herbal studies showing that many of them do work, after all).

Interestingly enough, one common way of avoiding controversy for false or misleading claims is to simply state the health claims as historical, ie- "traditionally used for treatment of the common cold". Note how this claim does not actually state that there is any medical evidence for its efficacy; it only states that it has been traditionally used thusly.

[Admiral Valdemar]

Neurology, as I say, is extremely complex. The main reason for having these problems is because we can't map the human brain or even a cluster of neurones accurately enough to see what a given compound will do to them. This is also the main reason for animal testing being used today. Until computers can simulate in real-time - the brain - what is essentially the most mind-bogglingly complex and advanced machine known, then physical tests have to be done. No doubt the recent anti-depressant scares that have hit the likes of GSK, Pfizer and so on will tie in with animal testing issues currently going on over here too.

On another note, the "traditional" treatments excuse was parodied in a Beecham's Cold Remedy ad from GSK which highlighted the laughable old cures used for the cold; from rubbing mustard on your chest to having a frog on your head. People seem hesitant to apply this reasoning to, say, homeopathy despite it being just as bloody useless (probably the same psychology linked to Intelligent Design gaining a following today, while flat-earthers are mocked) which doesn't help the drug companies save lives with things that do work like herceptin or monoclonal antibodies.

[Sea Skimmer]

Canada and Europe are starting to crack down on unsupported claims, but it's a tricky thing to do. At what point do you draw the line between folksy home remedies and pharmaceutical drugs? Will we ever get to the point that it's illegal to tell people that chicken soup is good for the common cold without peer-reviewed clinical studies which cost hundreds of millions of dollars to conduct (and which no one will therefore be willing to pay for unless there's a patent and big profits in store for them?)

Well the first thing to do would be to make the distinction between advertising something as treatment for a condition and as a cure for a condition. The former is a gray area, but if you claim you have a cure then you’d better prove it.

[Darth Servo]

Well the first thing to do would be to make the distinction between advertising something as treatment for a condition and as a cure for a condition. The former is a gray area, but if you claim you have a cure then you’d better prove it.

That has some merit to it but it brings up the issue of most people aren't smart enough to know the difference.

[Admiral Valdemar]

That'd certainly help. The news has been full of herceptin, mentioned above, which is a chemotherapy for breast cancer. The drug is pricey at around £10k a year per patient, but it cuts re-emergence of a cancer by 50%. The problem is the media hyped it up as a "miracle cure" (like every new drug or diet) and this added to the controversy of one trust denying the drug to someone.

People are stupid, there's no denying that, and not everyone can afford to go to med school and get that MD. So it is up to the medical community to properly explain how and why things are done as they are done. Antibiotics for the flu? No, because viruses aren't alive and antibiotics are of limited use thanks to bad prescriptions. Is all surgery risk free? No, even routine procedures can end fatally if an unforseen complication arises. You demonise alternative medicine because it doesn't make you big bucks for the drug firms! Wrong, they are discriminated because they just don't work, and those that do, the drug firms lap up and sell anyway.