Guild & Blackmores “naive money-grubbing action”

Today’s Letters to the Editor in Fairfax’s The Age offer ample criticism and no praise for the Blackmores scam (see PDF below) outlined here recently. Pharmacist and health store proprietor, Ian Collins writes;

AS A pharmacist and health store proprietor, I find the guild’s action of linking with one company a most naive and money-grubbing action. To be forced to recommend one company bringing out a new range of products, whose composition has not been widely discussed and has no track record, is beyond belief. To attempt to give all people with blood-pressure problems, no matter what the cause, one formula, ignoring all other health factors, is incomprehensible.

There are so many other products from different brands that may be more effective, products with a history of being useful; why pick this small range of untried products? Maybe the answer is that complementary medicine is basically ignored in pharmacy degrees and very few pharmacists have the knowledge to discuss or ask the relevant questions regarding complementary products.
How embarrassing for pharmacists to be caught with their hand in the till.

Prominent Mornington skeptic Graeme Hannigan writes;

I AM a health consumer and am disgusted at this agreement. If it wasn’t enough that pharmacies credulously offer such quackery as ear candles and the good old magic water of homeopathy, the agreement with Big Quacka means that any lingering vestiges of trust in pharmacies has vanished. Pharmacies are putting financial objectives well ahead of the ethical treatment of customers.
All guild pharmacies should come with a health warning and advice to customers to wash off the snake oil after visiting their pharmacy. I trust the guild will also make available the results of the peer-reviewed randomised double-blinded clinical trials of Blackmores Companion preparations so customers can make informed choices.

In a comprehensive Opinion article, Dr. Ken Harvey digs for some evidence to back this caper, finding little more than a business deal. He writes in part;

So what is the evidence to support the use of Blackmores Companions products?

Its Biotic Companion contains the probiotic strain Lactobacillus reuteri, which is claimed to reduce antibiotic-associated bloating, flatulence and diarrhoea. The risk of suffering these side-effects is relatively low. There is some evidence certain probiotics may reduce the incidence of antibiotic-associated diarrhoea in some populations, but routine use is not recommended by medical authorities. In immune-compromised patients, occasional cases have been reported where probiotic organisms have caused serious blood-stream infection.

Anti-HT Companion contains zinc gluconate to complement use of antihypertensive therapy. There are occasional reports that such therapy may lower zinc levels, but I am unaware of any independent medical authority that recommends routine zinc supplements with antihypertensive drugs.

Stat Companion contains coenzyme Q10 and vitamin D3 allegedly to support statin use. Muscle pain occurs in about one to two patients in 1000 receiving statins, especially if a high dose is used. The evidence that coenzyme Q10 and vitamin D3 can relieve statin-associated muscle pain is not clear-cut and the evidence that taking these ingredients together with statins prevents muscle symptoms is even less clear. As a result, the routine use of CoQ10 and vitamin D in statin-treated patients is not recommended.

PPI Companion contains magnesium to aid use of proton pump inhibitors. There are only occasional reports of clinically significant magnesium deficiency occurring in the many patients receiving PPI therapy. If this rare problem is diagnosed, the recommended management is to stop the PPI. Routine supplementation with magnesium for all patients on PPIs is not recommended.
The fine print of the material Blackmores provides about its products states that if a nutritional deficiency is suspected, pharmacists should refer customers to their GPs for further investigations. I agree.

When the rare person develops a nutrient deficiency on a prescription drug, the evidence-based approach is to confirm the diagnosis objectively with a blood test, case by case, and then treat accordingly. Sometimes that might mean prescribing a supplement. There is some evidence to support that.

But what the Pharmacy Guild-Blackmores arrangement implies is supplementation en masse, in the hope nutrient depletion will be prevented. I am unaware of any good evidence to support that. More importantly, this deal unnecessarily adds to the ”medication burden” and financial cost that many elderly patients already struggle with when taking multiple drugs.

Debate over the lack of evidence to justify the move as patient, not profit oriented, was also reported in Pharmacy News. CEO of APESMA, Chris Walton observed;

We are deeply concerned that pharmacists are increasingly being asked to put their expertise and professional ethics aside by pharmacy owners more interested in making money than doing what is in the best interests of their patients

Blackmores promotional material

Blackmores’ black heart: Would you like lies with that?

One can be forgiven for wondering exactly how pharmacist members of The Pharmacy Guild of Australia, will keep a straight face when giving advice about medication.

Not that they don’t have the training to do so. Far from it. Which is what makes the money spinning deal to push Blackmores’ “companion products” to certain medications particularly galling. By it’s very nature this “Coke and fries” (to use Blackmores term) deal is predicated on pharmacists pre-empting doctors and making on the run diagnoses. Diagnoses that they aren’t equipped to make and that may also prove deleterious.

The scam works like this. Blackmores have identified key prescription medicines and isolated potential “nutritional consequences”. They’ve proposed a “companion product” to the prescription with scant regard to the fact that no standing recommendations exist. More so, research into this approach to supplements is both ambiguous and has revealed negative effects.

The four areas you should be terrified about are:

  • Proton pump inhibitors and magnesium deficiency with muscle cramps, vertigo, hyper-irritability, excitability and the inevitable poor concentration. But if you can remember where you’re going for long enough you can limp to the chemist, stagger from wall to wall and unleash your hyper-rage upon stock to ensure a swift diagnosis.
  • Antibiotic treatment, upset GI microflora and the need for probiotics helped along by icky stories of bloating, farting and diarrhoea. Fear not you gaseous, smelly, splattering assault upon polite society, for they have just the probiotic for you.
  • Anti-hypertensives and zinc deficiency along with poor immunity, poor appetite, impaired sense of taste and smell. Topped off with poor skin health (delayed wound healing), GI tract issues with the inevitable diarrhoea which compounds zinc deficiency. Can’t eat, can’t heal, can’t taste, can’t smell and you’re stuck in the toilet. There’s a plus in there somewhere but no doubt you need a zinc supplement.
  • Statins (cholesterol lowering drugs) and myalgia plus (get this) “muscle soreness”. Along with cramping, weakness and fatigue, you clearly need Coenzyme Q 10 and vitamin D3. What a pity you’re already too shattered to get out of bed.

Of course dealing with the nutritional consequences, may have… er, consequences. For example Blackmores go on to tell consumers, CoQ10 may:

• Have hypotensive effects in patients with hypertension and may have additive effects on antihypertensive medications

• Interfere with some types of chemotherapeutic agents. Use with caution

• Decrease the anticoagulant effect of warfarin

• Decrease blood glucose levels in people on hypoglycaemic therapy

Vitamin D3 may theoretically cause hypercalcaemia if taken with thiazide diuretics. Caution is advised in those with hyperparathyroidism, malignancies that increase serum calcium levels or other risk factors for hypercalcaemia. Zinc may decrease absorption and blood levels of tetracycline and quinolone antibiotics unless doses are separated by at least 2 hours.

Magnesium may decrease the absorption and efficacy of tetracycline and quinolone antibiotics, bisphosphonates and chlorpromazine unless doses are separated by at least 2 hours. If using [Blackmores’ probiotic] with antibiotics to which [Blackmores’ probiotic] is sensitive, separate doses by at least two hours.

This is enough to make you pause and think about chatting at length with your doctor. There’s a few other useless spooky observations that the (s)CAM industry simply rock at pulling off. Such as vitamin D deficiency being widespread and associated with poor CV health. Magnesium contributes to healthy teeth, bones, muscle/nerve function, electrolyte balance and normal energy metabolism. Myalgia is one of the most common reported adverse effect of statin use.

Many patients – particularly older ones – may already have poor nutrient intake… 1/3 of Aussies over 18 don’t get the RDI of magnesium. My favourite is the veiled suggestion GP’s aren’t capable of doing their job: “…the TGA have advised prescribers to be alert to hypomagnesaemia in people taking PPIs”. To which I can easily imagine Professor Farnsworth from Futurama saying, “Why yes… which is exactly why cowboy’s like you should stay the hell away from grown up science”.

With the help of Dr. Ken Harvey, who we know here from the SensaSlim saga, we can pin down the extent of frivolity being advanced by this joint venture. The statin claims are particularly bold, given side effects. Also, noting Wyman et al;

Some small clinical trials seem to show that coenzyme Q10 supplements can be used to lower blood pressure and to treat or prevent myalgia caused by hydroxymethylglutaryl coenzyme A reductase inhibitors (statins). However, larger trials are needed to determine if they are truly effective for these purposes.

On the topic of probiotics, The March 2011 issue of Therapeutic Guidelines Antibiotic, states;

There is some evidence that prophylactic probiotics reduce the incidence of antibiotic-associated diarrhoea but the appropriate combination of agents has not been established, so probiotics cannot be recommended for routine use. In immune-compromised patients, occasional cases of probiotic-associated bacteraemia have occurred

Regarding zinc and magnesium supplementation there is no standing recommendation for use with anti-hypertensive therapy and PPI use respectively. As Farnsworth just reminded us, being on the lookout for symptoms is for trained health professionals. Blackmores’ hijacking of professional guidelines is just another trick for selling for the sake of it.

Consumers Health Forum of Australia chief Carol Bennett claims in Fairfax that the entire caper is unethical and urges consumers to demand evidence and report pharmacists who lean on fears. Geraldine Moses, who is a drug safety researcher reminds us of the folic acid related seizures epileptics sustained after taking a supplement to combat the reduction in folate specific to epilepsy medication.

Today The Age reported;

PHARMACISTS have been accused of putting money ahead of patients’ interests after striking a controversial deal to market dietary supplements with prescription medicines.

The Pharmacy Guild of Australia, which represents 94 per cent of Australia’s 5200 pharmacies, has agreed to start recommending a range of Blackmores products to patients when they pick up prescriptions for anti-biotics, blood pressure drugs, cholesterol medicine and proton pump inhibitors.

Last week, Blackmores chief executive Christine Holgate told Pharmacy News the deal meant they could provide ”the Coke and fries” with prescription drugs while providing pharmacies with ”a new and important revenue stream”.

Her comments prompted sharp criticism from doctors and consumer advocates who said it risked turning pharmacies into McDonald’s-like businesses that push products onto patients who do not need them. Under the deal, when a prescription is filled, a prompt in the pharmacist’s computer system will remind them to discuss a particular Blackmores product that has been designed to offset possible side-effects of their prescription drug.

[……]

Australian Medical Association president Steve Hambleton said the move was outrageous and smacked of commercial interest rather than clinical need.

He said he did not know of any solid evidence backing the combination of dietary supplements with the prescriptions included in the deal. ”I think the evidence for Coke and fries is about the same as the evidence for these products,” he said. Dr Hambleton said the recommendations had the potential to confuse patients, who should trust their doctors to prescribe them what they need without any conflicts of interest.

Geraldine Moses, a drug safety researcher and pharmacist based at Brisbane’s Mater Hospital, said she was concerned about the deal because of good evidence that the more drugs a person took, the more likely they were to have adverse reactions and interactions. She said while Blackmores may have evidence showing that prescription drugs reduce particular nutrient levels and that their supplements increase those nutrient levels, it was incorrect to presume that replenishing those levels was the right thing to do.

Outrageous, unethical and potentially dangerous according to experts. This is undoubtedly a grab for money targetting a demographic that is unable to afford trumped up scams with potential risks. Given the appalling performance of the alternative product industry in the recent Auditor General’s Report and concerns raised about regulation of same in the TGA Transparency Review in July, the Pharmacy Guild should be ashamed of itself.

I wish Professor Farnsworth could get a piece of them.

Homeopathy is baloney

A nice video montage of various clips relating to the pros (cough) and cons of homeopathy.

If homeopathically labelled it might read Facts 40C, Baloney 15C. This means that factual material has been vastly more diluted than complete baloney. Which means there’s more impact from fact in this video than hokery pokery. That in itself makes no sense – so we’re off to a good start.

The surprisingly honest episode of Today Tonight featuring Richard Saunders of Australian Skeptics is interspersed with other material. Paul Offit explains the uselessness of Oscillococcinum, James Randi pops in with a refreshing use of the words “health scam”. Simon Singh appears on the BBC and Aussie TV and we meet Mark Wild, a British filmmaker whose decision to use a homeoprophylactic for malaria almost killed him.

Don’t miss the hilarious Charlene Werner casually redefining Einstein’s equation whilst lecturing in homeopathy. And we thank “quantum healer” Joshua Bloom just for using the word “quantum”. Kudos to the guy from Futurama.

Scientology: Scam auditors allowed to audit themselves

The final report of Australia’s Fair Work Ombudsman [below] into the “church” of Scientology is welcome, yet unsettling in that the full scale of this criminal venture is overlooked.

For those keen to see some real action opening the way to revoke privileges in Australia to one of the globes most corrupt and abusive cults, the report offers mixed messages. On the one hand the pleas of Scientology that “volunteers”, are well looked after is shown up for the lie that it is. On the other hand the impact of the cult’s initiation, effect of abuse, forced labour and false imprisonment in perpetuating financial sleight of hand has not been taken into account.

It is not a secret that the cult uses a plethora of intimidatory tactics including imprisonment, degrading punishment, family separation and psychological abuse of members to ensure loyalty to intra-tribal mechanics. Specialists in casting the outside world as supremely dysfunctional and manifesting their own terminology to describe their sick brand of human nature, Scientology is beyond being a special case.

Thus it is absolutely unacceptable to read that the Fair Work Ombudsman;

…offers advice to persons giving their labour for free to any religious organisation that they should be mindful of their intentions in doing so and to the extent possible, protect their own interests and immediately withdraw their labour if they perceive that their relationship ceases to be truly voluntary.

Yesterday’s Fair Work media release states that the Fair Work Agency has determined;

  • To treat CoS entities which engage in trading activities as constitutional corporations for the purposes of the Fair Work Act and its predecessor legislation,
  • That a number of allegations raised by some witnesses fall outside the statutory time limit for consideration or cannot be sustained and are therefore unable to be pursued,
  • To continue to investigate allegations raised by one witness which relates to an entity known as Get off Drugs Naturally,
  • To refer to other relevant authorities allegations made against the CoS which fall outside its jurisdiction, and
  • To request that the CoS and its related entities conduct a comprehensive self-audit to ensure compliance with the Fair Work Act – and if employees are found to have been underpaid, for those underpayments to be rectified.

The impotence and hilarity of that last point “requesting” that the tin can brain auditors set about business auditing themselves in compliance with the law, cannot be overstated. The most significant defeat for Scientology is that;

The Statement of Findings says the Fair Work Ombudsman considered, but was not persuaded, by submissions from the CoS that the Fair Work Act did not apply because the church “is a religious entity … and there isn’t any worker relationship or employer relationship”. The Statement says documents and policies examined by Fair Work inspectors during the course of their investigation “plainly contradicted” this assertion.

The CoS described payments to church workers as being “a small amount to enable them to perform their duties by covering the cost of travel, babysitters, food and other expenses … not a reward for services rendered”. However, the investigation found several features of the arrangements within the CoS entities were not consistent with volunteer or voluntary work.

“In particular, witness evidence indicates that significant hours of work were imposed on workers. Further evidence indicates a significant level of control and direction was applied to workers by more senior church members who held positions of authority,” the Statement of Findings says.

The Statement says documents provided by the CoS indicate it is a “bureaucratised organisation” which appears to have imported practices and procedures into Australia with little thought to workplace relations laws.

They will, after trying every trick in the book, be held to some account and suffer some financial cost. In many ways of course, this also coaches Scientology in what not to get caught doing. They shall not make this mistake again.

Yet bizarrely the findings also offer a virtual free pass to Scientology. Indeed it’s enough bureaucratic bungling by the Ombudsman to have Xenu squirming as he orbits above in his battle cruiser.

We read that this global über-rich criminal powerhouse at whose feet Melbourne Lord Mayor, Robert Doyle fairly recently grovelled, may tidy it’s own room and, “…proactively undertake the self-audit at the earliest opportunity using a consultant that the Fair Work Ombudsman approves and who has no connection to the church”.

Oh, the LULZ dear reader, the utter LULZ of it all. I mean;

It requests the consultant be briefed to:

  • Review the procedures for the engagement of workers and to properly determine the applicable Modern Award and National Employment Standards for each individual,
  • Review the status of existing employees to ensure they are receiving their lawful entitlements,
  • Recommend the introduction of changes to record-keeping and issuing of play slips and the Fair Work Information Statement to ensure compliance with the Fair Work Act, and
  • Recommend a framework to the Church which enables the identification of relevant legislation relating to all employee entitlements, such as long service leave.

In regards to the unconscionable and widespread abuse at the hands of Scientology clones and beneficiaries (what the draft report called slavery, forced labour and false imprisonment);

Some claimed the use of unconscionable tactics by the CoS designed to retain their commitment. The Fair Work Ombudsman makes no findings in respect of those allegations, but advises that if workers providing services to religious or any other organisation consider that they are being subjected to intimidation or other illegal pressure to continue to provide their labour, they should contact police.

Which, along with “self auditing”, completely misses the point of ongoing and existing abuse within the criminal cult entire and is a rather pathetic anti-climax indeed.

Little wonder in the ever positive and innocent world of theta management, we hear from Australian president Vicki Dunstan, reportedly under investigation for her own illegal conduct surrounding human rights. Vicki has also disconnected from, and has nothing to do with her own sister for leaving the cult. Vicki’s daughter refers to the Scientology scam as “toxic” in that it tears families apart. Citing a deprived childhood she likens Scientology members to “cattle”.

So Vicki is perfect for an honest response to the report. She gushes;

Todayʼs decision is a terrific outcome for Australiaʼs charitable sector and for religious freedom. Our staff work hard to promote their religious beliefs and in a wide range of charitable programs in the areas of drug education, literacy, numeracy, human rights education and disaster aid. They do that knowing itʼs voluntary and do not expect to be paid for their efforts.

Charity doesn’t start at home for Vicki it would plainly seem. The Statement [below] included;

The Church has a long history in this country of fighting for human rights and religious freedom. Volunteers can help transform our communities for the benefit of all people.

Nearly two years has passed since baseless allegations run in the media prompted the FWO investigation. The Church now expects the authors of these allegations to apologise publicly to the Scientology community.

Far, far more work is needed post haste into this appalling scam. It’s close to grotesque that evidence bankrupt Narcanon and Crimanon – both recruitment front shops, remain active. Little surprise that Narcanon and Get Off Drugs Naturally comprise part of the Fair Work Agency investigation. Remember the Aboriginal drug bomb these fools came up with?

Worse is that the Senate Privileges Committee allowed Dunstan to respond in Hansard to Xenophon’s November 2009 allegations, lending a crucial soap box to the lies and scams of the cult in refuting allegations from brave ex-members.

So for now, the cult rolls on having already having transferred it’s registration from OFT to ASIC to circumvent further action under Fair Work legislation.

Lateline: Xenophon disappointed by Scientology report

Fair Work Ombudsman – Statement of findings

Scientology Statement on Fair Work findings

Scientology may face class action

Following revelations on ABC’s Lateline on September 13th about severe breaches of employment guidelines, it’s emerged Slater and Gordon have also been looking into the Church of Scientology practice of scamming workers.

Scientology have likened these workers, who signed employment contracts, received payslips and group certificates, to rural firefighter volunteers. Their statement is below. [C/O ABC Lateline]

Law firm Slater and Gordon is planning to take a class action against the Church of Scientology over claims the church has underpaid its workers.

STATEMENT FROM CHURCH OF SCIENTOLOGY