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Drug and supplements may look similar but are subject to very different rules and regulations.


Fear is a powerful motivator. And few events may be as frightening as a cancer diagnosis. It shouldn’t be surprising that the unscrupulous may try to take advantage of your fear in order to sell you something.

While the specifics vary by country, dietary supplements tend to be subject to weaker regulations than those for prescription and over-the-counter drugs. This includes the claims that can be made about a product. While drugs are subject to very specific marketing requirements, there may be more latitude given to manufacturers of dietary supplements. Even where regulations and requirements for these products exist, they may not be routinely enforced. In the United States, supplement vendors can make “structure/function” claims (e.g., “Helps maintain proper joint function”) but cannot make specific statements (e.g., “Relieves joint pain”). However, regular readers of this blog may recall many products promoted with claims that are not based on any credible evidence, or would be considered to meet regulatory requirements.

Canada has a similar, though not identical approach. Notably, prescription drugs cannot be advertised to the public in Canada, but “natural health products” can be advertised. Health Canada (Canada’s equivalent to the Food and Drug Administration) forbids treatment claims for natural health products for conditions like cancer, but does permit preventative claims, but only if those claims are approved by Health Canada. It’s a narrow window, that, if enforced to a science-based standard, could balance the desire to provide information on products while making sure statements are supported by evidence.

Recently the Canadian science advocacy group Bad Science Watch undertook a review of the online marketing of Canadian natural health products. Specifically, they looked at statements made regarding cancer, and whether or not those claims were appropriate and authorized by Health Canada. The results will not surprise you.

The approach

The overall intent of this survey was to develop and evaluate a methodology towards assessment of whether Canadian online retailers of natural health products were marketing their products in alignment with the authorization provided by Health Canada. The specific condition examined was cancer. Content from Canadian retailers was collected based on the keyword “cancer” (and related terms, like tumor or metastasis) and each statement was examined for accuracy. Both direct and indirect claims were identified:

Direct: e.g., “It is also important in the prevention and treatment of breast and colon cancer.”

Indirect: e.g., “”Bloodroot extracts have also been promoted by some supplement companies as a treatment or cure for cancer.”

The specific websites themselves were identified from a convenience sample from the Canadian Health Food Association Retailer Directory.

Twenty-three trained volunteers evaluated the claims for each page identified. Overall, 31,686 web pages were identified and ultimately 2,324 were screened. (Full methodology is here.) In the end, 558 unique web pages were identified, and this was what was found:

  • 20% (113) of web pages made a direct claim of treatment or cure
  • 30% (166) made an indirect claim of treatment or cure
  • Only 3 out of the 558 pages had claims that were Health-Canada-approved.

There’s an infographic of all of the results.

What this means

This isn’t the first post to remind you to be skeptical of what you read on the internet. Consumers facing frightening conditions like cancer may be tempted to try these products, despite the lack of evidence to substantiate these claims. As I have blogged before, dietary supplements appear to be, at best, neutral with respect to cancer survival, and there is no indication that they offer advantages or benefits to those that take them. We also know that cancer patients that opt for alternative medicine have higher rates of cancer death than those that use conventional therapies. It’s for these reasons that consumers deserve robust regulation, and enforcement of those regulations, to prevent these forms of opportunistic marketing.

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  • Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada. Scott has no conflicts of interest to disclose. Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.

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Posted by Scott Gavura

Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada. Scott has no conflicts of interest to disclose. Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.