Editorial: Simple Economics...

By Len Monheit
[email protected]

This week has been a significant one for the North American supplements industry. A Congressional hearing in Washington, held to discuss health cost savings through the use of certain supplements, was the culmination of study sponsored by the Dietary Supplement Education Alliance (DSEA) and conducted by the Lewin Group. The study found that billions in dollars of health system savings could be implemented through the use of two supplements - calcium + vitamin D and folic acid.

In all, five supplements were studied, and while the science was found to be compelling for omega-3's, glucosamine and saw palmetto, the economic model to substantiate healthcare system savings could not be completed for these other three supplements. Obviously this increases the urgency of ongoing research at the NIH and at other facilities and institutions so that the scientific evidence is conclusively determined, and that the economic benefits conclusively established.

From the current results for calcium especially, a key factor in the accuracy, relevance and even credibility of the data presented, is that a single, easily identifiable health condition, ‘hip fractures in the elderly’, was chosen for the analysis of cost impact. These results should serve as a positive future lever for additional economic impact studies, as well as for the benefit/risk analysis we can expect to see more of by the FDA, other government agencies and even the medical community. This study (http://www.supplementinfo.org/healthimpacts/healthimpacts.htm ) also serves as a platform argument and response to industry critics seeking to make blanket statements about the irresponsible and non-beneficial supplements industry. It should not serve, however, as a call for all supplements companies to begin flogging low quality supplements with inconclusive or inadequate bioavailability data.

Ideally, a result such as this is followed up be several 'next steps' including further studies (scientific and economic), calls for industry activity and investment, and calls for specific government action and supports.

In Canada, the Canadian Health Food Association (CHFA) issued their own press release based on the study results (http://www.newswire.ca/en/releases/archive/September2004/22/c2451.html ) specifically asking the Canadian Federal government to:

1. Allocate funds to educate consumers on the preventative role of

natural health products with proven potential for reducing health

care costs.

2. Provide financial incentives, which would allow natural health

products to be claimed as a medically deductible expense.

3. Encourage provinces and territories to add licensed natural health

products to provincial drug formularies.

4. Support further studies for natural health products that demonstrate

their potential to positively impact health status and health care


In an example of excellent timing, Nutrition 21, the manufacturers of Diachrome®, presented early results of an economic analysis conducted by Thomas Jefferson University’s Department of Health Policy, which indicated that use of Diachrome® as an adjunct nutritional therapy for people with type 2 diabetes could offer significant healthcare cost savings - savings in the order of $405 and $729 per person annually in treatment costs, with further analysis and research to be performed.

Once again, the prerequisites to gather this type of data are: overwhelming scientific evidence and hard economic impact results measured against a specific health condition.

Measuring reaction to this study, especially initial media reaction, is difficult. Industry critics will have their usual ammunition and arguments and when called upon by the media to provide perspective, are only too glad to do so.

A major PR push went behind this hearing and study release and we'll have to watch to see what kind of editorial and general coverage it triggers over time. The initial coverage was ‘good’ to ‘neutral’ with an AP article covering the study and the hearing being picked up on most newswires. Another story, picked up on Hearst Newspapers, included comments from Bruce Silverglade, legal director of the Center for Science in the Public Interest, in which he dismisses the study as a PR exercise, comments about Rep. Dan Burton's, (R-Ind.) "hearings that are essentially trade shows," and notes that the real issue is tougher regulations.

This type of response makes it obvious that the current study is a great start, but only that, and that when put in complete context, doesn't suddenly justify the industry's existence or the merits of all industry companies. Also, while the study notes a requirement of 1200 mg of calcium with vitamin D to reach the cost benefits, if certain products do not meet label claim, then are we really any better off for this significant study result?

I commend DSEA for initiating this study and the companies and organizations which have supported DSEA. I look forward to additional science, additional economic impact analysis and better industry communications so that we make appropriate use of all such findings and research.

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