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Internet sees growth of unverified health claims

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7054.381 (Published 17 August 1996) Cite this as: BMJ 1996;313:381

There are a growing number of dubious health claims for products on the Internet which British authorities say they are powerless to control. These include advertisements for shark cartilage, which “inhibits tumour growth and cancer,” and melatonin, which is banned in the United Kingdom but freely available in the United States and is claimed to “strengthen the body's immune system.” These and many more are easily available by mail order to anyone with an Internet connection.

In the UK, terrestrial advertising for such products in the high street and other media is restricted by law. Products making “medicinal claims” must have a product licence supported by scientific evidence. Although there is controversy over what constitutes such a claim, companies found in breach can be penalised.

But Graham Fowler, a spokesman for the Advertising Standards Authority, said that, whereas British companies advertising on the Internet must adhere to the same restrictions as are in place for printed advertisements, the authority has no control over foreign companies. “If the Chinese government and the CIA can't regulate the Internet what chance have a couple of blokes in Tottenham Court Road?” he said.

Punching a simple search phrase such as alternative medicine brings up hundreds of links to mail order companies, largely based in the US, offering a wide variety of substances for any ailment. These range from combinations of “synergistic herbs” to a menu of “phase three trial drugs,” with no apparent restriction on who might order from the hotline.

One highly advertised drug, no longer in the British National Formulary and not approved by the Food and Drug Administration, is DHEA, or dehydroepiandrosterone. Once used as a hormone replacement therapy, it is now billed on the web pages of dietary supplement sellers as the producer of the body's “sexiest hormones” with the ability to “extend your life.” DHEA, it is claimed, will help prevent or improve cancer, obesity, diabetes, Alzheimer's disease, aging, osteoporosis, cholesterol, and brain function.

Dr Mike Cullum, clinical director for oncology services at University Hospital, Birmingham, describes such claims as simply “garbage.”

“In cancer services, it doesn't help us to have patients arrive with piles of information about some unavailable, ineffectual, and possibly poisonous product and asking when we can start their treatment.”

And though most patients take a sensible approach if the demands of scientific evidence are explained, Dr Cullum said that countering the hype was likely to become increasingly time consuming. Indeed, a recent survey by British consumer magazine Health Which showed that 40% of people who regularly use dietary supplements believe them to be medicines despite the restrictions on claims.

Dr Cullum noted, however, that the Internet also has its good uses. In collaboration with the patients' lobby group BACUP, he and colleagues are developing the Cancer-helpUK website, an information database that will eventually offer detailed information on every tumour site.

According to Dr Peter Fellows, chairman of the BMA's general practice prescribing subcommittee, advertising on the Internet is still less of a problem than what is going on in the high street.

“People who have access to the Internet are likely to be more intelligent and better off and not so easily duped by duff advertising.” But he added that any product claiming to have a health benefit should be subject to the same controls as licensed drugs.

He said that BMA representatives are due to meet members of the Royal Pharmaceutical Society of Great Britain shortly to discuss increased controls on such borderline substances.—HILARY BOWER, medical journalist, London

Figure1

Melatonin is banned in the United Kingdom but available throught the Internet

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