France’s 200-Year-Old Love Affair With Homeopathy Is Under Siege

(Bloomberg) -- In virtually every French family’s medicine chest, there’s at least one tube of spherical pills that look something like Tic Tacs. Just like the mints, they consist mainly of sugar and melt pleasantly under your tongue, but these aren’t candies. They’re homeopathic meds with Latin names like Arnica montana and Passiflora that many French and their doctors swear by.

Now these alternative remedies for aches, stress, insomnia and more are under siege as a debate rages over whether the government, which subsidizes about a third of their costs, should continue to pay.

A health panel is set to rule at the end of the month on the future of funding for homeopathy, a 200-year-old practice that critics dismiss as ineffective and possibly dangerous. Unlike the riotous Yellow Vest movement, this controversy hasn’t spilled onto the streets. Instead, the pro-homeopathy forces are mobilizing for a fight via social media, organized meetups and leaflets handed out in pharmacies across France.

The looming brawl gets to the heart of conflicting visions of the state’s involvement in the country’s health system at a time of eroding quality and services. Jobs are also at stake: France is home to Boiron SA, the leader in a global homeopathy market estimated at more than $30 billion.

Boiron’s pills and tinctures have long coexisted with conventional care in France, prescribed by regular doctors and dispensed in almost every pharmacy. Ending public support for the remedies would discredit homeopathy and “send a shock wave” through the industry worldwide, says Boiron’s chief executive officer, Valerie Poinsot.

“We’ve been caught in this storm for the past year,” Poinsot says. “Why the hostility, when we contribute to caring for patients?”

Critics say the pills are no more beneficial than the Tic Tacs they bring to mind, and that state funding legitimizes homeopathy, encouraging some to shun conventional medicine just when they need it most — treating a deadly cancer, for instance.

Facing a possible backlash, Boiron, based in Lyon, teamed with rivals Weleda AG of Switzerland and closely held family group Lehning to fund a campaign called MyHomeoMyChoice. The push has garnered just over 1 million signatures in an online petition and placed bright-colored posters framed with the recognizable little white pills at pharmacies across the country.

“Homeopathy has treated generations of French patients,” says one slogan. “Why deprive future generations?”

For now, French people can walk into any pharmacy and buy a tube of Arnica granules — recommended for shocks and bruises — or roughly a thousand other similar remedies for 1.6 euros ($1.80) with a prescription, because the state health system shoulders about 30% of its cost. In some cases, private insurers cover the remainder and patients pay nothing. That may all soon change. A science agency is wrapping up a study of the relative benefits of alternative medicine that will inform the government’s position: Keep the funding, trim it or scrap it altogether.

If the government cuts funding, Boiron would instantly feel the pain. Poinsot estimates that sales of reimbursed treatments could plummet by 50% in France, where the company brings in almost half its revenue. The company’s stock price has lost about 13% since May 15, when a French newspaper wrote that the panel reviewing homeopathy funding would probably rule against it.

France’s public health system needs money and the government is cutting costs, but homeopathy doesn’t weigh heavily in the balance. The cost to the public health system was about 127 million euros last year, less than 1% of overall pharmaceutical spending. This fight is more about diverging views of alternative medicine and the state’s role than savings.

The tide has already turned against homeopathy elsewhere in Europe, notably in Spain and the U.K., where the National Health Service advised doctors to stop prescribing such remedies in 2017, saying it is “at best a placebo.”

In France, the controversy first erupted last year when the influential Le Figaro newspaper published a letter from a doctor’s collective called FakeMed lambasting alternative medicines. The authors called for ending support of “irrational and dangerous” therapies with “no scientific foundation.” The ensuing debate prompted Health Minister Agnes Buzyn to place funding under review and ask the country’s High Authority for Health to rule on homeopathy’s scientific merits.

That’s where things got complicated. Homeopathy’s purported method of action requires a little suspension of disbelief. The medicines are made by diluting an active ingredient (think tree bark, squid ink or snake venom) to the point where there’s little or no discernible trace left — suggesting the water that held them retains some memory of the original structure.

If that sounds wacky, plenty of French say au contraire. Boiron’s Poinsot points to a five-year series of surveys among physicians, funded by the Lyon-based company and conducted by independent scientists. It found that patients treated with homeopathy for muscle and bone pain, anxiety and respiratory infections had outcomes similar to those consuming more costly conventional remedies such as antibiotics, antidepressants and painkillers.

It’s unclear whether anyone in France has been harmed as a result of using homeopathy. Some regulators warn of quality risks and few high-profile scientists endorse the approach or its underlying system. But one who does is a star: Luc Montagnier, the French virologist who shared a Nobel Prize for discovering the HIV virus. He says water appears to retain a signal from substances that dissolve in it, lending credence to the dilution concept.

Critics see homeopathy through an entirely different lens and dismiss Montagnier as an aging eccentric. They view alternative meds as unscientific, dangerous and a waste of public funds.

David Beausire, a doctor in palliative care at the hospital in Mont de Marsan, in southwest France, is among those who signed the FakeMed letter. Beausire, who sees many terminally ill patients, said he regularly gets people who consult too late because they first explored alternative medicine paths that include homeopathy.

“I am not an extremist,” he says. But homeopathy’s reimbursement by the state health system gives it legitimacy when “there’s no proof that it works.”

The takeaway from clinical studies is murky at best. A review by the nonprofit Cochrane Collaboration found no impact beyond a placebo in children with respiratory tract infections. Similarly, Australia’s medical research council concluded after a review of 157 studies that the evidence didn’t provide a high enough level of confidence to support efficacy.

Proponents say trials intended to evaluate a single drug targeted to a single ailment don’t work well for homeopathy, which tailors remedies to patients based on their profile and personality — not their symptoms, as is the case with conventional medicine. So two people with an ear infection may not walk out of the doctor’s office with the same prescription.

“Homeopathy is a form of personalized medicine,” says Florian Petitjean, president of Weleda in France and a pharmacist by training. “That’s really the crux of the problem.”

Stung by accusations of quackery, Antoine Demonceaux, a doctor and homeopath in Reims, founded a group called SafeMed last November to relay the message that homeopathy has a role to play alongside standard care. He points to the growing number of cancer centers offering consultations to relieve treatment-related symptoms, such as nausea, with homeopathic medicine.

Demonceaux says neither he nor his colleagues would ever use homeopathy as a substitute for treatments intended to, say, shrink tumors.

“A general practitioner or a specialist who’d claim to be a homeopath and to cure cancer with homeopathy? Just sack him,” he says. “Let’s get real. We are doctors.”

To contact the editor responsible for this story: Rick Schine at eschine@bloomberg.net, Mark Schoifet

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