Prescribing functional foods could cut drug costs

That is the opinion of Dr Gordon Surgeoner, president of Ontario Agri-Food Technologies​, a not-for-profit organization that exists to encourage the use of biotechnology by the region's agricultural and food industries.

The Ontario government spends almost 50 percent of its annual budget on health care, compared with 35 percent twenty years ago, and in Canada as a whole around C$1.1 billion is spent each year on cholesterol-lowering drugs alone. Minister of Health Ujjal Dosanjhhas said that overall drug costs are expected to go up $391 million this year.

Dr Surgeoner believes that tens of thousands of dollars could be sliced off the drug bill through prescription of foods, resulting in significant savings for the government - and therefore the taxpayer.

"We need to find new ways to protect consumers but also to keep costs down,"​ he told NutraIngredients-USA.com.

For example Omega Pro, an egg product, has been shown to reduce triglyceride levels by between 25 and 30 percent, the same amount as cholesterol-lowering drugs like Lipitor, but at a fraction of the cost.

But Dr Surgeoner said that there are several barriers standing in the way of prescription of food products. Of these, regulatory restrictions are first and foremost.

Unlike in the United States, functional foods cannot make claims on their packaging. Dr Surgeoner and Ontario Agri-Foods Technologies are involved in lobbying ministers to introduce such a system for products that have solid scientific data demonstrating health benefits.

Furthermore, food products are currently excluded from health care plans, so that while a patient's prescription drugs arecovered, at present they would have to pay for any functional foods prescribed out of their own pocket.

Dr Surgeoner also said that the onus is on food companies to carry out clinical trials, but that only those that invest in the science should be able to make the health claims.

"Why should someone who didn't pay for a study benefit from it?"​ he said.

In the United States, companies have been permitted to file health claim petitions with the FDA for the health properties of ingredients since 2003. But if approved, these can be used by every company making products in the category, which means there is no competitive incentive for filing the petition in the first place.

Dr Surgeoner suggested that companies which do not carry out research themselves could license the right to use health claims from those that do, or that there should be an exclusivity period of, say, five years.

As for physicians, pressures on their time mean that they cannot always reinforce the foods message.

"It is much easier to take a pill than it to change one's entire diet"​, said Dr Surgeoner.

By introducing more nurses and dieticians into the healthcare system, more time could be devoted to devising dietary approaches to suit each patient's individual needs, whether in conjunction with or instead of prescription drugs.

The vast amounts of money spent by pharmaceutical companies on promoting their products to physicians is also a factor in their preparedness to prescribe drugs over recommending a dietary approach to ailments.

"To some extent it comes into play,"​ said Dr Surgeoner. "But drugs are critical to good health as well."

In the United States, rising health care costs mean that more and more consumers are turning to self-administered alternatives such as complementary and alternative medicine and diet.

A study carried out as part of the Centers for Disease Control and Prevention's 2002 National Health Interview Survey found that more than a third of American adults now use complementary and alternative medicine, with almost 20 per cent of these taking natural products, such as herbs or other botanicals.

But Dr Surgeoner expressed concern at consumers' self-administration of functional foods: "I worry about overdose, as there is no control on dosage,"​ he said.

Nor is there any uniformity in the functional content and performance of products across the market. For example, one product containing a health-promoting ingredient such as omega-3 could be a very different formulation than another, and therefore have a different effect.

Consumers are not necessarily able to differentiate, and without proper guidance they can easily become confused.

Euromonitor figures show that the function foods industry in the US was worth $52.16 billion in 2004, and it is expected to grow to $69.25 billion by 2009.