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Why do treatment scams work so well?

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Health care watchdogs have had their hands full this week. From stem cell treatments to hormone rebalancing to the 3-parent baby technique, unapproved medical treatments are being marketed everywhere. Unapproved and largely unproven and untested, these treatments can lead to significant physical and financial harm. Given the high risks, high cost, and lack of evidence, why do these treatments gain popularity? After an enlightening “tweet chat” with experts about #stemcellhype, we have a few ideas:

Direct-to-consumer marketing is effective

Advertising works! Ads for stem cell treatments in publications like The Seattle Times and the San Francisco Chronicle promise a natural cure to dozens of conditions with no pain or side effects. Direct-to-consumer advertisements for testosterone treatment have been increasing, with a corresponding rise in demand for the treatment in regions where the ads are shown. Mixed in with ads for FDA approved drugs, it’s hard for consumers to tell the difference.

It’s hard to tell good from bad evidence

How’s a consumer supposed to tell the difference between a treatment backed up by valid evidence, versus a treatment where the evidence is either bogus or completely lacking? The FDA has approved stem cell treatments for some conditions (for example, certain cancers and immunologic and blood disorders) but not others. According to stem cell researcher Dr. Leigh Turner, stem cell clinics have started adding their names to the list of clinical trials on clinicaltrials.gov, so when people browse the website, they think the clinic is conducting a real trial, when in fact they are doing no such thing.

Another factor is the prevalence of industry funding and bias in published medical journals. More than 80% of clinical trials are funded by drug and device companies, which calls into question the legitimacy these studies. Literature reviews that take conflicts of interest into account like those from the Cochrane Collaborative are extremely valuable, but unfortunately there isn’t a Cochrane review for every treatment on the market. One contributor to the #Stemcellhype tweet chat summed up the problem:

 

Professional endorsements legitimize scams

Dr. Jen Gunter, a doctor who regularly calls out lifestyle blogs for promoting ineffective treatments, chided Gwyneth Paltrow’s blog this week for the “ludicrous” suggestion that people can rebalance their hormones by touching plants. Unfortunately, Paltrow’s woowoo medical advice gets reinforced by none other than our new CDC director Dr. Brenda Fitzgerald, who believes that hormone treatments increase vitality and lessen the effects of aging, a theory that has not a lot of science behind it.

Lack of science isn’t stopping prestigious medical centers from making a buck on homeopathic and alternative treatments, as Arthur Caplan and Timothy Caulfield write in STAT. The good news is, reiki and cupping can’t hurt anybody. But when both FDA-approved and unapproved treatments are advertised in the same way, when medicines backed by research turn out to be deadly, and when doctors provide check-ups and anti-aging treatment in the same clinic, is it any wonder that consumers are confused?