21 OCTOBER 1938, Page 11

PATENT MEDICINES AND THE LAW HI

By A SPECIAL CORRESPONDENT

[This is the third of a short series of articles on the evils arising out of the unrestricted advertisement and sale of patent medicines. In a fourth and concluding article next week Lord Horder will outline the reforms which in his judgement are needed in this country] SO great are the profits and the financial resources of the patent medicine industry that it is easy to understand the Government's reluctance *.o introduce restrictive legisla- tion. But before we express sympathy for the Government's difficulties we must be sure of the facts. Lord Gage, replying on behalf of the Government to the suggestion made in the House of Lords by Lord Horder, said it was very difficult to see what could be done to restrict the activities of the patent-medicine-vendor. Therefore the first question that calls for an answer is this : Have other countries, other free and democratic countries, succeeded in curbing the activi- ties of the patent medicine quack, and in giving a reason- able amount of protection to the public ? The answer is, yes.

Let us look, first, at the Scandinavian countries, because they have always led the field in matters of social legislation. In Denmark all patent medicine advertising in the public Press is forbidden. That is to say there has been in existence since 1932 a law which absolutely prohibits the advertising (in the Press or elsewhere) of goods purporting to have a curative, disinfecting or prophylactic effect. Such advertising is tolerated only in professional publications directed to doctors, dentists, veterinary surgeons and chemists. This law does not, of course, prevent the unrestricted advertise- ment of such products as aspirin. But it does stop the boosting of " cough cures," digestive remedies and similar products. In this connexion it is interesting to note that a product well known and widely advertised on the British market recently came under this ban when an attempt was made to advertise it in Denmark. Its publicity was found to make exaggerated claims, and until these were toned down its sales campaign had to be postponed. It rests with a Court of Law to decide in each individual case whether or not the law has been broken ; in practice all newspapers refuse to accept doubtful advertisements.

In Norway a law has been in force since 1930 whereby no patent medicine or pharmaceutical product may be advertised in any way, or even sold, without the authority of the Medical Board of the Ministry of Health. Newspapers do not there- fore accept patent medicine advertising unless the letterpress has been approved by the Medical Board. And the letter- press is not approved by the Medical Board if exaggerated claims are made, or if the retail price bears no relation to the cost price of the product. A sample of the medicine has to be sent to the Board, together with an analysis and a statement of the retail price the dealer intends to charge for it. If the product is injurious it cannot be sold ; if the retail price is too high, it has to be reduced ; if the advertising is too strong, the soft pedal has to be put on. Control of this kind is facilitated by the fact that no one can open a chemist's shop without the approval of the Government. The sale of chemicals and drugs is considered to be a form of public service at least as important as the practice of medicine ; and when a properly qualified dispensing chemist wants to open a shop he has to seek Government approval. This depends on the recommenda- tion of the Ministry of Health. Multiple trading is forbidden in Norway, so there are no great dispensing companies, with thousands of branches, ready to apply mass selling methods to mass-produced patent medicines. No doubt this also has a restrictive effect.

In Sweden the regulations are not quite so strict, but it is apparent that the authorities want to give the Swedish public the same sort of protection as is enjoyed by the Danish and Norwegian. There is in existence, however, a regulation which prohibits chemists from selling " dangerous " patent medicines except against a doctor's prescription. A list of " dangerous " medicines is regularly compiled by the Ministry of Health ; and it may be noted that it now includes concen- trated vitamin products, which, as is well known, are poisonous if an overdose is given—and it is very easy to give an overdose. Late last year a Commission set up by the Ministry of Health recommended that concentrated vitamin products should be manufactured or imported only with the authority of the Medical Board at the Ministry of Health ; and that this authority should be withdrawn if the product were " improperly " advertised.

Any product which is not included in the pharmacopoeia of each of these three countries cannot be bought, or even privately imported, in any of them. If, for example, a resident in Sweden wants to buy from Great Britain a patent medicine, or even a specially prepared medicine, which is not included in the Swedish pharmacopoeia, he can get it through the Customs only if a Swedish dispensing chemist (who by virtue of his Cabinet appointment is something of a. civil servant) is willing to approve of a permit for its entry.

The American public is also given better protection than the British. The Federal Food, Drug and Cosmetic Act, passed in the summer of this year, prevents any person from " introducing into interstate commerce any new drug " unless an application has first been filed. If the Secretary of Agriculture finds that the drug is unsafe to use, or that the drug is manufactured under such conditions as not to give adequate guarantees of the quality and purity of the drug, or if the information given to him by the manu- facturers is insufficient, he is authorised " to refuse to permit the application " to sell the drug to become effective. As regards drugs already on the market, the new Act gives the public protection against adulteration, misrepresentation, and against the possibility of unknowingly taking a " habit- forming drug."

The American Act goes much further than the Food and Drugs Act in this country which received the Royal Assent in August of this year. The obligation of the prosecution to prove fraudulent intent on the part of a defendant has been rescinded in America, and what was almost an insur- mountable obstacle to successful prosecution has been removed. In England the obstacle remains as impassable as it was in 1914. The American Legislature has found a solution of the difficulty by the simple process of declaring it an offence to make false claims of curative .effect on the labels of patent medicines, whether or not the claims were made with fraudulent intent.

This sort of legislation is, of course, extremely useful so far as it goes. But Scandinavian experience suggests that more is to be gained by raising the professional status of the dispensing chemist, and that so long as the chemist is looked upon as being a mere retailer, like a greengrocer or a newsagent, it will be difficult to give the public all the protection it ought to have against the patent medicine quack. The battle against the patent medicine ramp will have been won on the day that mysteriously-shaped bottles in bright and sensational wrappers cease to appear in chemists' shop-windows, on the day, that is, when the dispensing chemist again looks upon himself as an apothecary rather than as a shop-keeper.