The most recent meeting of the MEP Interest Group on Complementary and Alternative Medicine (CAM) took place on 1 July 2015 at the European Parliament. Hosted by MEP Sirpa Pietikaeinen (EPP, Finland), it focused on the gap in availability of CAM products and treatments in many EU Member States.
To kick off the meeting, MEP Sirpa Pietikaeinen recalled that a large number of people in Europe – currently estimated to be about 50% of the population – have already used CAM products, which testified to rising consumer demand and a growing economy. However, Member States deal very differently in terms of providing market access to CAM products, in many cases denying patients the right to make use of such products.
Dr. Ton Nicolai, President, European Committee for Homeopathy confirmed the strong increase in demand over the last two decades and provided an overview of the sector, linking its popularity with the growing desire of individuals to take responsibility for their own health. He highlighted that CAM products could contribute to a reduction of antimicrobial resistance (AMR) and outlined their potential benefits for managing chronic diseases, which include cost-effectiveness, restoring the body’s natural system, adoption of healthy behaviours, and fewer long-term care needs. Moreover, CAM products and treatments generally pose no problems for patient safety .
Nicolai further explained that, while the legislation of CAM medicinal products was an EU competence, their registration remained national: it was at this level that practices differed widely between Member States as a result of different statutory regulations. Moreover, although a 2014 report by Matrix urged the Commission to ‘address the issue of unavailability’, the European Commission has stated that ‘national competent authorities have not confirmed availability problems’.
Rene de Winter, European Federation of Patients’ Association for Anthroposophic Medicine (EFPAM) argued that the integration of CAM products and treatments into the health system was becoming more important for providing the best possible person-centred care. It was also an issue of freedom of choice as currently, users had ‘freedom of no choice’ in many countries, with often inexplicable differences (e.g. relatively good availability in Germany vs. growing restrictions in the Netherlands and ‘mail-order only’ in Norway) when the quality and safety of the products was the same across Europe.
Herbert Schwabl of DaKoMed (Swiss umbrella organisation of Complementary Medicine) informed participants that the availability of herbal medicinal products had not improved in spite of DIR 2004/24/EC on traditional herbal medicinal products and the establishment of a dedicated Committee on Herbal Medicines Products (HMPC) at the European Medicines Agency. Due to differing interpretations at country level, the legislation remains unsuccessful, and the European Commission’s suggestion to register such products as food supplements does not sit well with CAM stakeholders given the differences in scope between the two categories. Schwabl therefore called for a strengthening of the HMPC and establishing a mutual recognition procedure.
Stephen Gordon of the European Central Council of Homeopaths (ECCH) agreed that ‘mutual recognition should be simple but isn’t’, noting that the heads of medicines agencies had themselves produced a report on availability of CAM products. He called for a more harmonised and consistent approach across Europe and asked the Commission to take the findings of the Matrix study and of other such reports more seriously at a time when polypharmacy (the use of four or more medications by a patient, generally older people) represents a serious problem.
Dr. Madeleen Winker, International Federation of Anthroposophical Medical Organisations (IVAA) reported on the situation in the Netherlands where only 50 registered products remained on the market. Medical professionals used them to help treat various conditions including acute asthma, allergic reactions, pneumonia and hypotension, yet this well-established use was not reflected in the legal framework.
A representative of the Commission’s Joint Research Centre deplored the strong differences in availability of CAM products and treatments across Europe and wondered whether the JRC could support the sector by producing evidence-based studies and reviews, with further support offered by MEP Pietikaeinen.