PMDC prohibits prescription of nutraceuticals

ISLAMABAD: Despite strong opposition of the health ministry’s directives regarding the prohibition on prescribing nutraceuticals, the Pakistan Medical and Dental Council (PMDC) on Thursday endorsed the federal cabinet and Ministry of Health’s decisions, directing all the healthcare professionals to refrain from prescribing multivitamins, minerals and food supplements to the patients.

“The PMDC, in its meeting on February 23, 2024, perused the decision of the federal cabinet taken on February 6, 2024, received through M/o National Health Services, Regulations and Coordination on February 13, 2024.

The PMDC has directed all the concerned authorities to ensure compliance of the cabinet’s decision,” a notification issued by the PMDC said.

The Ministry of National Health Services, Regulations and Coordination had earlier directed the PMDC to “prohibit the prescription of all vitamins, multi-vitamins, minerals and health and over-the-counter products by physicians /doctors and medical and dental practitioners”. The PMDC had also been directed “to take all necessary steps forthwith, including amendment, if any, in code of practice and ethics for the medical and dental practitioners under section 47 of the Pakistan Medical and Dental Council Act, 2022 (Act No. IV of 2023).”

Despite the directives from the health ministry as well as regulatory authorities, the healthcare professionals are continuously prescribing nutraceutical products including multivitamins, minerals and food supplements, arguing that in many cases, patients essentially need these products for their treatment and recovery from certain health conditions.

“Millions of children in Pakistan need micronutrients and oral zinc for the treatment of diarrhea, while women need standardised iron folate or multiple micronutrients as well as calcium supplements in pregnancy as per global and WHO recommendations.

Why is their use being restricted as these are all registered products with the Drap and part of the government’s essential drug lists,” questioned Dr Zulfiqar Bhutta, a pediatrician and health scientist.

Former Special Assistant to the Prime Minister (SAPM) on Health Dr Faisal Sultan also expressed his reservations on the ministry’s notification regarding ban on nutraceuticals prescribing, saying although vitamins, minerals and supplements were being used for unproven or non-scientific indications, there were many very clear scientific uses of them too.

“Vitamin A is used for the treatment and prevention of measles, night blindness, xerophthalmia, vitamin B1 for chronic alcohol use, wernicke encephalopathy, korsakoff psychosis, beri beri and thiamine deficiency, vitamin B2 for riboflavin deficiency, vitamin B3 for dyslipidemia and pellagra, while vitamin B6 for Isoniazid (TB treatment drug) to prevent neuropathy,” he explained. Several other healthcare professionals, gynecologists, orthopedic surgeons and even pharmacists criticised the health ministry for a blanket ban on prescribing nutraceuticals and demanded the ministry to come up with clear guidelines for prescribing them on the pattern of US Food and Drug Administration (FDA) and National Health Services (NHS) of the UK.