When the public thinks of the complementary medicine industry, their attitudes are generally overwhelmingly positive, with the perception is that it is a quaint, harmless cottage industry.

However, complementary medicine is big business — over $3 billion spent in Australia on products alone — and the days of it being dominated by passionate practitioners setting up small family businesses are long gone.

Yet the public still views companies like Blackmore’s and Nature’s Own (not actually a company but rather a brand owned and very recently sold by health conglomerate Symbion) more positively than it does pharmaceutical companies like Pfizer or AstraZeneca.

But these companies are multinational pharmaceutical enterprises. Blackmore’s may have grown out of Maurice Blackmore’s passion for naturopathic medicine, but now it is a company that turns over more than $150 million annually and is listed on the Australian Stock Exchange.

Symbion further blurred the lines between complementary and pharmaceutical medicine companies by being both — in addition to owning pharmacies and pathology services — and has recently sold its complementary medicine business to French pharmaceutical multinational Sanofi Aventis for $560 million.

These two companies dominate over half the over the counter retail complementary medicine sector. Many of the other brands are more than likely manufactured by one of the four companies that dominate contract manufacturing in Australia.

Make no mistake, these are big companies. Whilst this in itself isn’t concerning, it simply means they should be approached for consultation with the same trepidation afforded to pharmaceutical companies.

Therapeutic goods companies maintaining their interests in the corridors of power is nothing new — Big Pharma has been in the practice for years. But apparent opposition from practitioner groups may also represent other interests. The Australian Traditional Medicine Society is Australia’s largest professional association with around 11,000 members. It is also represented in more government committees than any other and its well resourced media department is often the first point of call for media groups garnering industry opinion. It is also vocally opposed to any form of regulation.

However data from the University of Queensland suggests that nearly 90% of complementary therapists are supportive of regulation. So why wouldn’t the largest professional association support the views of its practitioner members?

Unlike other professional associations, the board of the ATMS is not democratically elected but is appointed by what it terms executive members — representatives of complementary medicine education and training providers. Therefore the views of the association represent the views of the complementary medicine private education sector — a sector conservatively estimated to be worth over $60 million annually. Other smaller associations — most often supportive of regulation — are rarely consulted at all.

The public is familiar, and appropriately wary, of the influence that interest groups such as Big Oil and Big Pharma can play in politics. However, few are aware of the powerful financial and political interests that determine the decisions and advice of Big CAM in developing complementary medicine policy and opinion.

These well funded industry lobby groups have many more opportunities to consult and influence government than do consumer or smaller interest groups. This is particularly concerning considering these institutions are most often the ones consulted by the government for advice and opinion on regulatory issues as they are thought to be those most representative of industry opinion.

Ken Harvey has already commented on the importance of industry regulation. But as long as those advising the government continue to exhibit such dramatic conflicts of interest, these will continue to win out over those of public health and safety. These very clear conflicts of interests highlight the need to establish and develop independent advisory panels or diversify sources of advice relating to complementary medicines.