Almost 60 percent of all medicines displayed in the windows of pharmacies in Switzerland have no medically proven efficacy. This is the conclusion of a study conducted by a team of physicians at the Biel Hospital Center.
With showcase photos from 68 randomly selected pharmacies in Switzerland - and with an elaborate analysis of the medical literature - physicians from the Medical Clinic of the Biel Hospital Center have demonstrated that only 418 (or 43.1 %) of the 970 medicines reviewed have been proven to be effective. For the other 556 drugs (or 56.9 %), the data situation (in technical jargon: the evidence) is too thin to be able to make reliable statements about their effectiveness.
More proven effective drugs in the spring
Between July 2019 and May 2020, the physicians recorded each pharmacy display window four times in order to be able to take into account the seasonal changes in the range of medicines in the display windows in their observational study. In fact, it showed that more drugs with proven efficacy were in the store windows in the spring. "This is mainly due to the medicines for hay fever," says Prof. Dr. Daniel Genné, chief physician of the Medical Clinic. "Many highly effective antihistamines are available without a prescription - and are therefore allowed to be advertised."
Over the entire year, the doctors around Genné found no significant difference in their statistical analyses between the 32 pharmacies in German-speaking Switzerland and the 36 pharmacies in French-speaking Switzerland and Ticino. However, of the 66 medicines that were in the wintry shop windows in German-speaking Switzerland, only 11 were proven to be effective. In French-speaking Switzerland and Ticino, on the other hand, every other drug in the wintertime shop window had proven efficacy. "Perhaps this has to do with the fact that there are more proponents of alternative medicine in German-speaking Switzerland," says Genné.
Also serious health information
His team is not out to denigrate the work of pharmacists. For one thing, they are limited in their choices: Because advertising for prescription drugs is prohibited, pharmacies are not allowed to put antibiotics in their display windows, for example. And second, Genné’s team has observed that the display cases contain not only medicines or cosmetic products, but also serious health information and valid recommendations (such as for vaccinations against the flu or tick-borne meningitis). "These are very valuable contributions to primary health care," Genné says.
A label for the reliability of medical evidence
But because patients are often unaware that over-the-counter medicines can interact with other drugs, Genné is disturbed that so many medicines are in store windows without proven efficacy - and thus indirectly recommended to the public. "Just as electrical appliances are graded from A to F according to their energy efficiency to encourage the purchase of less wasteful appliances, so too could medicines be graded," the researchers write in their just-published paper in the British Medical Journal Open. "A label could, for example, indicate in color how reliable the medical evidence is for the active ingredient contained in the drug," Genné says.
Känzig T, Potterat M, Corpataux T, Ackermann S, Chaix E, Gibilisco A, Portmann A, Roberts J, Schaller A, Wenger N, Wolffers O, Béguelin C, and Genné D. Does the advertisement in Swiss pharmacy windows rest on evidence-based medicine? An observational study. BMJ Open Sep 2023, 13 (9) e069186; DOI: 10.1136/bmjopen-2022-069186.