Patterns and Trends in the Use of Herbal Products,Herbal Medicine and Herbal Medicinal Products

Abstract

Used as authorized medicines or dietary supplements herbal products gain a rising and high interest by patients as well as by health care professionals. In industrialized countries, 10-50 % of the population regularly uses herbal products. According to surveys, the main reason to use herbal products in these countries is the assumption of a better tolerability compared to synthetic drugs. Whereas in developing countries herbal medicines are mostly the only available and affordable treatment option. Surveys from industrialized countries reveal as main health areas in which herbal products are used upper airway diseases including cough and common cold; other leading causes are gastrointestinal, nervous and urinary complaints up to painful conditions such as rheumatic diseases, joint pain and stiffness. Risks associated with the use of a (herbal) medicinal product are assessed by health authorities during the approval procedure and is monitored during marketing by systematic continuous pharmacovigilance activities. This process favors authorized or registered herbal medicinal products.

Figure 1. Interest in herbal medicine as shown by the absolute numbers of publications on herbal drugs in PubMed, obtained with search terms for all publications on `herbal medicine? OR `phytotherapy?
(white bars; reduced to 1/10 of size), all publications on `herbal medicine? OR `phytotherapy? AND clinical/controlled clinical trials (gray bars), and all publications on `herbal medicine? OR `phytotherapy?
AND safety aspects (`adverse reactions or events?; black bars); searches were conducted by using relevant medical subject headings (MeSH) for the calendar years 1990 to 2016 Medcrave.

Comparison chart

Introduction

The interest in the practical use of herbal substances and preparations for medicinal purposes is growing continuously worldwide. This is reflected by numerous publications describing the interest of consumers and patients, e.g. from epidemiological studies, by an increasing number of scientific publications including those on randomized clinical trials (RCT) [1] in the worldwide literature as well as by publications which deal with specific aspects of the therapeutic use of herbals or herbal medicinal products, e.g. reviews, meta-analyses or safety aspects.

The present article highlights some aspects of the use of herbal or botanical substances and preparations for medicinal purposes globally and specifically compares two different markets as examples: the German market with predominantly authorized herbal medicinal products (HMP) and the market in the United States with almost exclusively herbal or botanical dietary supplements.

Definition and Regulation

The Word Health Organization(WHO)defines herbal medicines(HM)as remedies containing crude “herbs, herbal materials, herbal preparations and finished herbal products that contain as active ingredients parts of plants, or other plant materials, or combinations” [2]. This definition covers three different categories: a) authorized herbal medicinal products according to the European Union framework for medicines regulation [EC 2001/83], b) botanical or dietary herbal supplements used for medicinal purposes like in the United States and almost all other countries, and c) single, individual preparations that are prepared and/or used by the consumers themselves or prescribed by a herbal practitioner, a physician or a pharmacist.

In industrialized countries with sufficient medicinal care, the use of herbal products and preparations for medicinal purposes and/or of herbal medicinal products (HMP) is considered as part of Complementary and alternative medicine (CAM) [3-5]. Herbal (botanical) products (HP) of these different categories, including dietary supplements as authorized HMP, are used as an alternative medicine to synthetic pharmaceuticals or as a complementary medicine together with synthetic pharmaceuticals.In developing countries, which represent the majority of the global human population, the use of herbal preparations for medicinal purposes has quite a different but very important significance: in such countries without adequate medical care by hospitals and/or local physicians and/or without an established health care system, traditional (herbal) medicines are usually the only available and affordable treatment [6]. This applies, for example, to some countries or regions in Latin America and Africa where health care is
not available to all population groups [6-10].To the extent that the use of herbal products for therapeutic purposes is substantiated by sound scientific data on quality, safety and efficacy, as required for the authorization of HMP in the European Union, their use is medicinally justified. The appropriate medicinal use is best described in well recognized herbal monographs provided, for example, by the Committee on Herbal Medicinal Products (HMPC) of the European Medicines Agency (EMA; available via www.ema.europe.eu), by the European Scientific Cooperative on Phototherapy (ESCOP; available via www.escop.com) or by the World Health Organization (WHO; available via apps.who.int).

Registration C and NC Expert Reports - Studies, Germany
Tankred Wegener, Registration - C and NC Expert Reports- Studies,
Brueckstrasse 11, 69469
Weinheim, Germany, Email: t.wegener@consulting-hmp.de

Citation: Wegener T (2017) Patterns and Trends in the Use of Herbal Products, Herbal Medicine and Herbal Medicinal Products. Int J Complement Alt
Med 9(6): 00317. DOI: 10.15406/ijcam.2017.09.00317 http://dx.doi.org/10.15406/ijcam.2017.09.00317