Mahvash Jahandar, a single woman in her early forties, owns an independent pharmacy business in a market town in the East Midlands, an increasingly popular location for commuters and young professionals, with good schools, shops, and access to London by train in around 80 minutes.
Mahvash employs three staff and a trainee. The business is doing well enough, but there is competition from Boots, other pharmacy chains and other pharmacies. Mahvash is acutely aware of her margins and what she needs to make to maintain her pharmacy.
Mahvash likes to keep up to date with as much as possible in current affairs and likes to surf online during her lunch break. Today she comes across a just published article:
“An advisory panel to the Food and Drug Administration agreed unanimously on Tuesday that a common decongestant ingredient used in many over-the-counter cold medicines is ineffective.
The panel’s vote tees up a likely decision by the agency on whether to essentially ban the ingredient, phenylephrine, which would result in pulling hundreds of products containing it from store shelves.
If the F.D.A. ordered their removal, a trade group warned that numerous popular products — including Tylenol, Mucinex and Benadryl cold and flu remedies — might become unavailable as companies race to reformulate them.
Agency officials generally follow the recommendations of the advisory panels, though not always, and it could take some months before a final decision is made. And the findings could be contested, prolonging any move toward product substitutions or removing certain stock at stores.
In the meantime, experts advised consumers not to panic or toss out all the drugs in their medicine cabinet. Even though the agency’s advisers have decided the ingredient, phenylephrine, doesn’t work to relieve nasal congestion when taken orally, it is not dangerous, and the products do contain other ingredients that will work to ease cold symptoms.
https://www.nytimes.com/2023/09/12/health/cold-medicine-decongestant-fda.html
Mahvash finishes her sandwich and looks across at her cold remedy shelves, well-stocked with remedies including Sudafed (https://www.sudafed.com/products/sudafed-pe-sinus-congestion), Benadryl and Vicks flu relief, all of which contain phenylephrine. These are all paid for and cannot be returned currently under the arrangement she has with her suppliers.
It’s early January, mid-winter in England, peak time for colds and ‘flu. Her cold and flu relief stocks are among the most popular of her products, and customers seem happy.
Arguably, these products are mostly or entirely useless, but people want them and are willing to pay. Should she remove them immediately? Since her pharmacy is based in England, should she Ignore the fact that the American FDA wants them pulled from the shelves? Should she continue to stock and sell these and similar items? Should she explain the latest science to each customer who wants this type of cold relief? Should she make information leaflets to hand out? Should she place a prominent warning in the shop?
MHRA (https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency) in the UK haven't issued any advice on this, but the FDA have. So, although there is nothing technically wrong with selling these products in the UK at the moment, it doesn’t alter the ethical issue for Mahvash since she is very much aware of the research and legal action in the US.
And, crucially, if she does this, should she take a similar approach with other products that are either not proven to be effective, or are known to have little or no positive effects?
What should Mahvash do?