One of Australia’s foremost research centres in complementary medicine has overplayed the benefits of natural therapies and omitted to tell the public about complementary medicines that it knew did not meet their label claims, former employees have claimed.
My beef with [NICM director] Alan [Bensoussan] is he never criticises complementary medicine which deserves criticism and I suppose that’s one of the problems with getting into bed with industry – you don’t want to bite the hand that feeds you.
Professor Ken Harvey
The National Institute of Complementary Medicine (NICM) is in the process of appointing a $2.9 million professorial chair sponsored by the Jacka Foundation of Natural Therapies, which has naming rights on the position and will be involved in selecting the successful candidate.
But analytical chemist Frank van der Kooy said the Western Sydney University institute had become so reliant on industry support that it was over-emphasising the benefits of complementary medicine and downplayed negative results.
Dr van der Kooy resigned from NICM in September after he raised concerns about the lack of independent research taking place, after which his position in the institute became increasingly untenable.
“I expected to be able to go and test things and get to an answer: does that work or does that not work?” Dr van der Kooy said.
“But the way they do their work, they always get a positive answer. Their funds come from industry, so you can’t find a negative result.”
Academics are perennially uneasy about the creep of corporate sponsorship into universities.
About 30 per cent of all health and medical research is funded by the private sector and federal government is encouraging more collaboration between academia and business, though such arrangements are typically closely regulated by ethics committees.
Last year the University of Sydney was forced to defend its decision to establish a chair of integrative medicine sponsored by Blackmores.
He points to several examples in which studies that found slight or mixed benefits of complementary medicine were hailed by NICM as proof of efficacy.
These included a study by the NICM director Alan Bensoussan that compared Chinese traditional medicine treatment plans for irritable bowel syndrome and was published in the Journal of the American Medical Association.
The abstract emphasised that patients in the active treatment group had a significant improvement over patients taking the placebo, but a critique of the study in the British Medical Journal found this was an “optimistic interpretation” of its findings.
While the Chinese medicine was superior to the placebo in several respects, there was no difference when it came to the main measure – the “bowel symptom score”.
Professor Bensoussan said his was a rigorous study that was highly cited and its findings were “accurate and not misleading”.
“The results showed statistically and clinically significant improvement in irritable bowel syndrome in both standardised and individualised Chinese medicine treatment groups by end of the 16 weeks intervention when compared to a placebo,” Professor Bensoussan said.
The NICM was established in 2007, four years after the Pan Pharmaceuticals scandal prompted the largest recall of medicines in Australian history and an expert committee called for more government-funded research into complementary medicines.
It pulls about $1 million annually from external sources, which is matched dollar-for-dollar by Western Sydney University.
External revenue is usually split equally between competitive funding, donors and industry, which pays the institute to perform analytical testing on raw materials or finished products through its commercial laboratory.
Fairfax Media has seen internal email correspondence that shows the laboratory knowingly performed tests on products that did not meet their label claims, which bothered staff because such therapies continued to be sold to the public.
But Professor Bensoussan said it was not the role of the laboratory to bring these concerns to the attention of the Therapeutic Goods Administration, only to to notify the client, whose responsibility it was to rectify the problem or pull the product from sale.
“It is the TGA that is responsible for monitoring breaches of label claims – not NICM,” Professor Bensoussan said.
“However, if NICM’s testing results demonstrated that a product contained high risk or dangerous contents (contrary to label claims), it would immediately notify the TGA.”
Monash University public health professor Ken Harvey said NICM was forced to rely on industry funding because, like all university departments, it did not get enough government funding to perform independent research.
“My beef with Alan is he never criticises complementary medicine which deserves criticism and I suppose that’s one of the problems with getting into bed with industry – you don’t want to bite the hand that feeds you,” Professor Harvey said.
“He has become a kind of apologist for the industry.”
Professor Bensoussan said he was saddened by that claim.
Blackmores and Catalent have commissioned contract research services and provided untied sponsorship to NICM, while SFI Flordis has provided sponsorship only.
Complementary Medicines Australia stated in its 2012-13 annual report that it was focused on building a relationship with NICM, “in particular to support product claims”.
Similarly, email correspondence indicates that Homart Pharmaceuticals commissioned NICM to conduct research where the goal was to prove an Australian herbal product was superior to the Chinese one.
But Professor Bensoussan said NICM did not conduct research for sponsors in the manner described by Homart, but was often asked to conduct preliminary research for efficacy, and it published all its results both positive and negative.
“It’s critical for our credibility,” Professor Bensoussan said.
Studies have found about 30 per cent of all health and medical research comes from industry and philanthropy.
“Complementary medicine is no different to the pharmaceutical industry. We understand conflict of interest concerns, but this is why we have strict guidelines and ethics committees and retain right of publication.”