FDA Regulation of Homeopathy - What's Smoke? What's Fire? and How to Put it Out.
Perhaps you’ve heard in the media lately about the Federal Drug Administration’s (FDA) regulation over homeopathic medicines. There has been a lot of attention paid to this topic in recent months. A good portion of that attention has maintained an alarmist tone. I wanted to follow-up on that topic and try to help make clear what’s smoke, what’s fire, and what the general public and supporters of the use of homeopathic remedies can do about it.
First, if you’re not aware of any of this, perhaps that’s just the best place you could be. Just keep seeking natural health for you and your family via homeopathy! However, if you are aware, I’ll try to give some background in the most concise and least-verbose way I can.
To begin, we must go to the source. In 1938 Congress passed the United States Food, Drug, and Cosmetics Act (FD&C), which established the Food and Drug Administration (FDA). Among other responsibilities, FDA is and always has been responsible for the manufacturing and labeling of drug products, including homeopathic medicine. The FD&C was led by U.S. Senator Royal Copeland, MD, who was also an ardent supporter and practitioner of homeopathy.
This Act of Congress effectively made homeopathic medicines legal drugs. Homeopathy was widely used in the marketplace prior to 1938, but were officially defined as legal. The FD&C also required any new drugs to have an approved application before marketing. This law has remained relatively unchanged since 1938. What has been added over time is information used to demonstrate safety and efficacy of any drug products, homeopathic or otherwise.
Part of the uproar over recent media coverage on this topic pertained to the recent FDA assertion that all homeopathic drugs are unapproved new drugs. This is not new information. They have always been unapproved new drugs as outlined by FD&C since 1938. Instead, and on three separate occasions in the past 40 years, FDA has stated that the best way to regulate homeopathic products is through enforcement discretion and regulatory guidance due in part to the knowledge that homeopathic products are safe. Effectively, no other FDA regulation is necessary.
In 1988, FDA adopted Compliance Policy Guidance (CPG) 400.400 (Conditions Under Which Homeopathic Drugs May Be Marketed). CPG 400.400 established clear standards for the manufacturing and sale of homeopathic drugs, and helps facilitate access to only safe homeopathic medicines to consumers. This is good for everyone – consumers (foremost), as well as manufacturers, and practitioners of homeopathy.
Beginning in 2015, FDA began public hearings on the regulatory framework for homeopathic medicines given that the current guidance (CPG 400.400) had been in place for over 25 years. Over 9000 comments were submitted. The vast majority (approx. 78%) were positive and in favor of homeopathy. The vast minority were not in favor of homeopathy.
FDA published their draft guidance on December 18, 2017. FDA guidance is nothing more than opinion. It is meant to inform FDA staff and the industry about what their priorities are. FDA guidance does not have the force of law, and cannot change the legal status of products. As such, homeopathic remedies have not been banned or are now suddenly unapproved for use, as some media sources and/or reports may state or imply. However, even though the opinion of an FDA guidance document is informal, it is still used to regulate homeopathic products.
Thus, the FDA guidance published in December 2017 highlighted six areas of priority, all of which primarily revolve around safety. Despite the legal status of homeopathic products remaining unchanged since 1938, there are several concerns about the FDA draft guidance, since it excluded important details and left too much room for ambiguous interpretation.
The American Academy of Homeopathic Pharmacists (AAHP) has been actively involved in this entire process. AAHP is asking for help in drafting comments to FDA to convince them to reinstate critical specific language into the draft guidance so that dangerous products can’t enter into the market, and only safe homeopathic products can. Having the public add draft comments will help amplify the industry message to FDA that this is an important issue for public health and to help facilitate continued access to homeopathic medicines. You can add your draft comments here. From that linked page, you’ll need to click the blue-colored button “Comment Now.” Please keep your comments congenial, thoughtful, and respectful. The comment period will close on March 18, 2018.
As part of the strategy to respond to the FDA draft guidance, a letter writing campaign has begun. This was a targeted approach and involved making contact with U.S. Members of Congress who are on committees which have jurisdiction over FDA. Constituents in those districts were asked to contact their Representatives and ask them to co-sign letters being sent to FDA. This amounted to people from six states including Tennessee, Washington State, Utah, Colorado, New Mexico, and Pennsylvania. As of writing, there has been an overwhelming response. If you are reading this and live in one of those six states, click here to find out how to take action.
The next phase of the strategic response is more of a grassroots effort. The letter writing campaign is set to go nationwide, beyond just those six states. Stay tuned for more details on how to take action on that approach.
Finally, Mark Land, President of AAHP has been instrumental in leading this effort to update the homeopathic community on the regulatory environment for homeopathic drug products. He presented a comprehensive free webinar on this topic, and you can review the recording of it here.
This was a lofty and information-intensive blog. Nevertheless, it contained critical paths for what is happening in homeopathy, and what we can do about it.
My hope is that this cleared some of the smoke on the topic of FDA-regulation of homeopathy, helped you see where the fire is, and how we can all help to put that fire out.
Contact me if you have any questions.
Thank you for reading, and for your support of homeopathy!
One of my main goals as a homeopath is to see classical homeopathy obtain a proverbial “seat at the table” when it comes to viable options within the American healthcare system. I would like homeopathy to be truly respected by all segments and levels of our society and be known and perceived as the effective, scientifically proven modality that it is. There are many ways this can be accomplished, but one way in which I have personally been involved is by serving on the Board of Directors as Vice President on the Council for Homeopathic Certification (CHC).
The mission of the CHC is “To advance the homeopathic profession by certifying individuals who meet and maintain a recognized standard of professional and ethical competence in classical homeopathy and to assist the general public in choosing appropriately qualified homeopaths.” Furthermore, the CHC envisions a healthcare system that encompasses certified classical homeopathic practitioners to be accessible to all.
One of the projects we’re working on at the CHC is lobbying members of Congress to attend a new bi-partisan Congressional effort (Caucus) led by Rep. Jared Polis, D-Colorado and Rep. Mike Coffman, R-Colorado. This Congressional Caucus will provide legislators and other policy and regulatory officials opportunities to understand how shifting focus in healthcare to prevention, health creation, and health promotion can create cost savings while improving health outcomes for Americans. We want homeopathy to be a more pronounced part of that conversation!
To aid in that effort, I am asking for your help. This call to action is about ensuring the elected members of Congress who represent you attend this important Congressional Caucus. Please visit the Integrative Health Policy Consortium (IHPC) website and find the contact information for your elected Representative. Call them and request they, or a staffer acting on their behalf, will attend. The Caucus is on March 15, 2018 from 12:00 – 2:00 p.m. (EST) in Washington D.C.
For more information about how the CHC is working to forge a path for homeopathy in Integrative Healthcare Reform, read the latest CHC Communique here.
Thank you for reading and for your support of homeopathy!