For those unfamiliar with the basic concept behind homeopathy – serial dilution – the Wikipedia entry will be helpful. The short version is that whatever “active” ingredient – herbs, minerals, duck liver – is so diluted in homeopathic product as to offer a vanishingly small chance of contact with even a single molecule of that ingredient. The theory is that the solvent – water, usually – somehow retains a “memory” of the original ingredient, and this somehow has therapeutic properties. Physicians consider this to be a form of quackery and often discourage their patients from acquiring these products, for good reason: they don’t want you to waste your money on water.

But that’s not how the people behind this study framed it. From their press release:

“In conventional oncology, oncologists or other conventional health practitioners may discourage patients from using alternative therapies due to a fear, rather than knowledge, about possible interactions. That may be due to confusion that homeopathic remedies are botanicals or herbs rather than highly dilute remedies that will not interact with drugs and are usually very safe.”

See, it’s not a test of whether or not the products work – it’s whether they have interaction effects. And they don’t. Because they’re water. Except when they’re not actually homeopathic remedies. This, from the bottom of the BBC article:

Edzard Ernst, professor of complementary medicine at the Peninsula Medical School, said there were “several problems with the body of evidence examined by this review.

“First, independent replications are lacking completely but would be necessary before we can accept any of these treatments in routine healthcare.

“Second, nobody doubts that undiluted remedies can have effects; and interestingly, the positive studies here seem to be on such medicines rather than on the highly diluted treatments which are a hallmark of homeopathy.

“In fact, the calendula cream found to be effective in one study is not diluted at all and thus it cannot, to all intents and purposes, be considered to be a typical homeopathic remedy.

“Finally, this review found hardly any high quality studies in the first place. So overall, this new piece of evidence simply confirms plenty of previous research demonstrating the unproven nature of homeopathy.”

You don’t get any of this from the headline. Nor is it clear that 6 of the 8 studies reviewed showed no evidence at all of any benefit, which is in fact the case. Instead you get a PR coup for an industry that preys on sick people. Thank you BBC for that.

Goozner makes clear that Postrel is wrong wrong wrong on the science, but she’s also wrong on the economics. Postrel implies that the incentive structure of the U.S. health-care system creates a unique market for “complex new drugs” – which, presumably, are more effective than simple old drugs. But the U.S. market is only unique in that it creates very expensive drugs. The drug companies don’t have any incentive (much less a requirement) to produce drugs that work better than older cheaper medicines, so they make drugs that cost a lot more with only marginal benefits. Goozner gets at this in his discussion of the studies behind Herceptin: there’s only an 8.4% improvement from the new drug over the old ones, at an additional cost of $60,000. This is a major flaw in our system: we’re spending a lot more money but not getting much more benefit. This is a manifestly unsustainable system, yet Postrel celebrates it because it “cured” her cancer.

The worst part of this article – even more than the shoddy science and economics – is Postrel’s appalling self-absorption. For all her talk about difficult “trade-offs” she yet ignores the fact that the system that makes her over-priced cancer drug available comes at the cost of tens of millions of people who can’t afford health care at all. The reason trade-offs “get harder” in public systems is that those decisions are foreordained in our system: rich people get health care, poor people don’t, and sick people get squeezed for every penny they can afford. The difference in publicly-financed systems is that these trade-offs are subject to public debate. Postrel might not like her chances in that system, but for the rest of us it’s more or less the definition of “democracy”.