Unregulated Healthcare – Supplements and Technology

By Brendan Moore

Half of all Americans regularly take at least one multivitamin. But despite such high prevalence in today’s society, the health supplements industry goes largely unregulated by the FDA.

So, on Tuesday, March 31st, the Roosevelt Institute met to discuss this critical policy issue in a discussion moderated by Leah Reiss and Allie O’Keefe. The discussion’s two focal points revolved around supplement regulation and the burgeoning mobile medical application industry.

 

Concerning supplement regulation, the multivitamins and health supplements that can be obtained without a doctor’s prescription are subject to insufficient regulation by the Food and Drug Administration (FDA) or are otherwise not regulated at all. In fact, a 2015 investigation by the New York State Attorney General into herbal health supplements sold at major retailers revealed that 80% of tested products did not contain any of the herbs stated on their label. The major deregulation of the supplements industry took place in 1994, when a lobbying campaign funded by drug companies convinced hundreds of thousands of Americans to urge their Congressmen to support the Dietary Supplement Health and Education Act, which grants firms rather than the FDA, responsibility for determining the safety and effectiveness of their products. This inherent bias in which companies act as their own regulatory agencies has led to many instances of falsely-marketed supplements.

There was virtually unanimity among Roosevelt members that increased oversight and regulation of the supplement industry was needed. However, there appeared to be an even split between those who advocated for the ends of regulation to simply prevent harm to the consumers and those who believed regulation should ensure not only safety but also effectiveness. Many members pointed out that reform in this sector of the healthcare industry is essential simply because of the vast number of people it affects. While there was one proposal for government to absorb all production of drugs and vitamins, most attendees were in favor of a more strictly regulated private sector for supplements in conjunction with increased education and awareness on the actual effectiveness of drugs. There was also general agreement that many supplements are not effective – yet there was dispute over reasons people continue to consume them at record amounts (i.e. placebo, advertisements). This was another impetus for many members to advocate for education on multivitamins and supplements towards the end of the discussion.

Regarding mobile application regulation, although there exists thousands of health and lifestyle related apps (i.e. MyFitnessPal, FitBit, etc.), only about 100 have been approved by the FDA. Moreover, it is estimated that 50% of the world’s 3.4 billion app users will be using a health-related app by 2018. It’s likely that insufficient app regulation has repercussions worldwide, as opposed to nuclear United States with supplement regulation (most countries have tighter regulation for supplements).

Many members of Roosevelt agreed that regulating and verifying the accuracy of these countless mobile apps would be a burdensome task not worth the labor intensive effort, especially when such efforts could be better channelled towards regulating the multivitamin industry. There was debate about websites such as webmd.com, where normal citizens are sometimes prone to inaccurate self-diagnosing. However, it was pointed out that because of the Affordable Care Act, where 16 million more Americans have access to healthcare than before 2013, possibly unreliable apps and websites will pose less of a threat to public health than in previous years. Moreover, members emphasized that most people know to take these apps “with a grain of salt,” and that if a possible medical issue arises, doctor consultation is traditionally the next step anyway.

Thank you for all of those who came out to the discussion!!