In a rare move, Walmart, the largest U.S. retailer, has been sued for medical fraud. The Center for Inquiry (CFI), a nonprofit whose mission is to “defend science and critical thinking in examining religion” alleges in a lawsuit filed in the District of Columbia on May 20 that the superstore is “committing wide-scale consumer fraud and endangering the health of its customers though its sale and marketing of homeopathic medicines.” This is similar to a suit the same nonprofit brought against CVS, the largest U.S. drug retailer, in June 2018.
Homeopathic medicine, or homeopathy, rests on the premise that the body can cure itself. Those who practice it believe microscopic amounts of natural substances can stimulate natural healing. According to the National Institutes of Health (NIH) National Center for Complementary and Integrative Health, an estimated 5 million adults and 1 million children used homeopathy in the past year. Most homeopathic oils, creams, tablets, and gels are self-administered and self-prescribed for ailments such as the common cold, migraines, allergies, and bodily pain.
Since homeopathy grew in popularity in Germany 200 years ago, it has been rooted in two primary theories:
- The notion that like cures like, meaning an ailment can be cured by a substance that produces symptoms similar to the ailment in healthy people.
- The notion that the lower the dose of medication, the greater the effectiveness. This means many homeopathic products are highly diluted by water or other means.
The idea that nature can cure has long appealed to humans. So because these products are deeply entrenched in human history, and they carry (minimal) labeling that they are not approved by the U.S. Food and Drug Administration, the likelihood of CFI winning its lawsuit is slim. But the filing has brought attention to the topic, which is also important.
One Molecule of This Substance Will Cure You
Alternative remedies have long been contentious as substitutes for evidence-based medication. In this case, CFI asserts that Walmart knowingly presented homeopathy like stress relief and cold and flu products as equal remedies, both in store and online. But CFI is not seeking to have products removed from shelves, but that Walmart labels its products accurately.
“Walmart sells homeopathics right alongside real medicines, in the same sections in its stores, under the same signs,” said Nick Little, a CFI vice president and lawyer. “Searches on its website for cold and flu remedies or teething products for infants yield pages full of homeopathic junk products. It’s an incredible betrayal of customers’ trust and an abuse of Walmart’s titanic retail power.”
While the NIH has determined there is little evidence to support homeopathy’s effectiveness at treating any mental or physical health problems, the FDA and Federal Trade Commission (FTC) have not taken major steps to curtail the industry. On May 14, the FDA did issue warnings to five manufacturers of homeopathic products, for putting, “consumers at risk with significant violations of manufacturing quality standards.” But so far this appears to be merely the agencies making an appearance at curtailing the products, since government agencies never review most homeopathic and nutraceutical products for safety or efficacy.
Despite CFI’s calls for tighter regulation of homeopathic products, very little has been done by federal agencies to date. However, the FTC declared that marketing homeopathic products for specific diseases and symptoms is only permissible if consumers are made aware “that 1) there is no scientific evidence that the product works, and 2) the product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.”
The FTC asserted that over-the-counter homeopathic products would be held to the same standard as those for evidence-based products making similar claims. It also stated (without a real enforcement mechanism) that homeopathic companies must have scientific evidence to make health-related claims.
In December 2017, the FDA also proposed a new “risk-based” enforcement approach to homeopathic products. The goal was to allow for more careful scrutiny of products that pose risks especially for vulnerable populations.
“Walmart can’t claim it doesn’t know that homeopathy is snake oil, because it runs its own enormous pharmacy business and makes its own homeopathic products,” Little said. “So whether it’s a scientifically proven remedy like aspirin or flatly denounced junk like homeopathic teething caplets for babies, Walmart sells all of it under its in-house ‘Equate’ branding. It’s all the same to Walmart.”
Like CVS, Walmart has the means to prolong the CFI suit for years. Further, although vague, the precedent has been established that “not approved by the FDA” on labeling is sufficient for store shelves. Thus, CFI’s goal of improving product labeling for consumers will likely not be a top priority for the courts or government agencies.
However, drawing consumer attention to the lack of scientific evidence supporting homeopathic products is never a wasted effort. The more information patients are armed with, the better. And unless medicine labels begin to resemble food labels, that FDA seal of approval should continue to be an important signal for consumers.
