The Pharmaceutical Board code of conduct requires pharmacists to practice in accordance with “the current and accepted evidence base”. By selling non-evidence-based remedies, pharmacist Ian Carr believes his colleagues are breaching that obligation. “For the possible short-term gain of supplement sales, we are risking our status as a profession,” said Mr Carr, a long-time critic of the close ties between pharmacists and the complementary medicine industry. Pharmacist Ian Carr is a vocal critic of the relationship between complementary medicines and pharmacies. Credit:Carl Muxlow His pharmacy in Taree on the NSW mid-north coast, generally does not stock complementary medicines, diet pills or other supplements.

It's a world away from pharmacy chains such as Chemist Warehouse, where a pharmacist dispensing highly-regulated, evidence-based drugs is surrounded by shelves and shelves of lightly regulated, non-evidence-based remedies. Some pharmacies now even have their own naturopath. Consumer group Choice conducted a shadow-shop of pharmacies in 2017; more than a quarter of their shadow-shoppers were recommended non-evidence-based complementary medicines or homoeopathic remedies by a pharmacist. There is no evidence homoeopathy works. “The trust in pharmacists I think is beginning to fall away,” said Dr Harry Nespolon, head of the Royal Australian College of GPs. A man browses for baby formula at a Chemist Warehouse store. Credit:Kate Geraghty

“Just talking to my patients, more and more of them just see them as salesmen. The sounds are just getting louder as the pharmacies look more and more like a supermarket.” And because the complementary medicines are being sold at the pharmacy, consumers think they are safe and evidence-based, Dr Nespolon says. This is not always the case.The Age and The Sydney Morning Herald have reported experts’ concerns that several common cold-and-flu busters, such as Echinacea and turmeric, come with more risks than people think. Amid these concerns, the Pharmaceutical Society of Australia recently wrote to major pharmacy chains, calling on them to pull homoeopathic remedies from their shelves because they were putting lives at risk. While some pharmacies responded positively, they never received a reply from Chemist Warehouse, Australia’s leading pharmacy chain, says society head Dr Chris Freeman. The company did not return a request for comment. The society strongly advises pharmacists against recommending vitamins, minerals, herbs, traditional and complementary medicines to the public unless there is strong evidence the benefits outweigh the risks.

Dr Freeman wants pharmacists to warn patients when they buy a non-evidence-based remedy. “We do have a duty of care in terms of giving them the information to make an informed decision," Dr Freeman said. The Pharmacy Guild, which represents pharmacy owners, says pharmacists have a duty of care to know about the evidence for all products sold in their stores. The Pharmacy Guild says pharmacists have a duty of care to know about the evidence for all products sold in their stores. Credit:Virginia Star "The Guild also acknowledges that it is the decision of individual pharmacy proprietors to stock a range of complementary medicines to meet customer needs." Dr Freeman rejected claims the profession’s reputation was at risk.

“Pharmacists have been consistently, over multiple decades, listed by consumers as one of the most trusted health professionals in the country,” Dr Freeman said. Others are more concerned. Professor John Dwyer, a former director of medicine at the Prince of Wales Hospital in Sydney, said “pharmacists have to face up to the fact many of us can see professionalism has gone out the window in place of profits”. “The number of pharmacies advocating remedies for which there is basically no evidence is really quite distressing, given these are men and women of science.” Both Professor Dwyer and Mr Carr are members of Friends of Science In Medicine, a group that lobbies against complementary medicine. Geraldine Moses, a clinical pharmacist at Mater Health Services in Brisbane, said she and her colleagues found the proliferation of alternative medicines “embarrassing”.