Oscillococcinum, or Oscillo for short, offers flu patients ages two and older a non-habit forming, non-drowsy flu treatment with no known drug interactions. Consumers can easily find Oscillo at respected pharmacies such as Walgreens and CVS Pharmacy. Better yet, six doses of Oscillo only costs $12.99, and it promises to reduce flu symptoms including body aches, headache, fever, chills, and fatigue. Oscillo vows to keep you safe each flu season with “[i]ndividually-packaged doses [that] are convenient to take anywhere so that you can be ready at the first sign of symptoms” (Oscillo). According to the Oscillo website, this medicine has been a very popular choice in 50 different countries for over 70 years. In fact, the medication “is a $15 million-a-year business, in the United States alone” (Park). Despite its financial success, this seemingly miraculous treatment is nothing short of a box of sugar pills. Upon closer inspection, consumers can see that Oscillococcinum is simply a well-marketed placebo that tricks customers in multiple countries around the world. In this article, I will provide a brief background of the “medicine” in question, uncover its persuasive and misleading marketing strategies, reveal scientific proof that Oscillo is ineffective, and discuss the ethical implications of marketing this placebo.
BACKGROUND:
Oscillo is manufactured solely by Boiron, a French producer of homeopathic goods. The company offers three different Oscillo selections: a box of six, twelve, or thirty doses. The word “Oscillococcinum” is spelled out in large blue san serif letters across the front of each box. The full name, which resembles Latin, gives the product a more scientific and trustworthy appearance. The orange stripes on the top and bottom of the box are reminiscent of vitamin C bottles, a reassuring characteristic considering vitamin C’s association with healthy immune systems. The front of the box reads, “Non-Drowsy. No Drug Interactions. Safe for Ages 2 & Up. Works Naturally with Your Body,” summarizing the product’s main selling points. On the back, consumers can find what appears to be a very detailed drug facts label. Admittedly, aside from the subtitle, “homeopathic medicine,” this product looks remarkably similar to clinically tested flu medication. For anyone in a weak and flu-dazed rush to find a fast cure, the packaging is enough to give the customer a false sense of security.
Boiron uses homeopathic philosophy to explain this seemingly miraculous flu cure. Invented in 1796 by German physician Samuel Hahnemann, homeopathy works under two guiding principles: the Law of Similars and the Law of Infinitesimals. The first law argues that “like cures like,” meaning that substances that give people specific symptoms also have the power to cure those same symptoms. This leads some homeopathic medicine producers to use “natural ingredients like salt or onions, but also substances like shipwrecks, light bulbs, the Berlin Wall and even vacuum cleaner dust or moonlight.” In other words, the active ingredients in homeopathic goods differ greatly from science-backed medicine. The second principle homeopaths believe is that the more you dilute an active ingredient, the more powerful that ingredient becomes (Gavura). These are the two homeopathic principles that guide Boiron’s preparation of Oscillococcinum.
Informed by the Law of Similars (or “like cures like”), Boiron uses a Muscovy duck for Oscillo’s active ingredient. Oscillococcinum was invented in the 1920s by French physician Joseph Roy, who reasoned that—since Muscovy duck carries a bacterial strain he believed to cause the Spanish flu—the duck’s heart and liver are the perfect solution to cure influenza.[1] With this guidance, Boiron prepares Oscillo by decapitating a Muscovy duck and fermenting 35 grams of its liver and 15 grams of its heart in pancreatic juice and glucose for 40 days. This fermented duck concoction “then undergoes serial dilutions (1 part in 100) 200 times in a row.” Finally, the diluted product is placed in tablets made of sucrose and lactose—otherwise known as sugar (Gavura). Boiron lists this fermented duck juice as Oscillo’s active ingredient: Anas Barbariae. Comically, the Latin for their active ingredient is incorrect. Anas Barbariae refers to Anas ducks, even though a Muscovy duck is used in Oscillo (Nienhuys). Boiron should have written “Cairina moschata” as its active ingredient. It is this mislabeled sugar concoction that is then sold to eager customers worldwide.
INITIAL SIGNS THAT OSCILLOCOCCINUM IS UNRELIABLE:
Before scrutinizing the claims behind Oscillococcinum, it is already apparent that Boiron is proliferating unreliable and illegitimate information. For example, the logic behind Oscillo’s effectiveness does not line up with current understandings of science. As Michael Shermer, a former columnist for Scientific American’s “Skeptic,” points out, any “extraordinary claim must be placed into a larger context to see how it fits.” To put Boiron’s extraordinary claim into context, one must understand that modern science argues that a substance can be diluted so much that it disappears from the mixture entirely. This scientific fact contradicts homeopathy’s second principle, the Law of Infinitesimals. Diluting a remedy does not make it more powerful, but Boiron still argues Oscillo’s power comes from its multiple dilutions. In short, Boiron’s “scientific” logic opposes modern science; it is a pseudoscience.
When dealing with pseudoscientists, Shermer urges us to acknowledge that they “often appear quite reliable, but when examined closely, the facts and figures they cite are distorted, taken out of context or occasionally even fabricated.” A close look at Boiron’s website promoting Oscillo reveals several fabricated facts. From misquoting research studies, to decreasing accessibility to information, to paying doctors for positive reviews, Boiron proves to be an untrustworthy company that distorts information.
First, Boiron distorts scientific research to support their agenda. The Oscillo website’s main page claims that Oscillo “has been shown in clinical studies to help reduce both the duration and severity of flu-like symptoms.” In order to find the sources for this, the reader must click a button titled “Learn About Oscillo,” read a separate page on the wonders of Oscillo, and then scroll down to the bottom of the page to find two MLA citations for clinical studies. The first source comes from the British Homeopathic Journal, which has a clear bias towards homeopathic remedies, like Oscillo. The second source, from the British Journal of Clinical Pharmacology shows much more promise. However, since the website provides only MLA citation for this source—instead of an accessible hyperlink to the article—it is up to the consumer to dig through the clinical journal’s issues to find this particular information. Despite including hyperlinks for other sources of information, Boiron specifically chose not to include easy access to this study, and for good reason. Boiron misleads its customers to believe that this second study proves Oscillo’s effectiveness. In actuality, Ferley et al., the research team behind this second article, conclude, “[I]t would be unwise to claim that the study has demonstrated a cause and effect relationship between the drug and the recoveries” (334). In other words, the second article, which Boiron cites as clinical proof, actually suggests that Oscillo is ineffective and likely has no effect on flu symptoms. Upon closer inspection, Boiron never properly supports the claim that clinical studies back up its work. Instead, Boiron uses hidden bias (with the first cited article) and distortion (with the second cited article) to sell its product.
Second, Boiron decreases accessibility to information, another sign that the company’s claims are unreliable. While Boiron includes a disclaimer that the Food and Drug Administration has not evaluated Oscillo, this information is placed at the very bottom of the page with the option to exit out of the disclaimer as if it were an annoying ad instead of an important notice.[2] It is also disheartening to note that Boiron’s Spanish page, “Información del Medicamento,” does not include a Spanish warning about Oscillo not being evaluated by the FDA, meaning that Boiron is denying Spanish speakers crucial information. By making these choices, Boiron creates its own narrative that decreases consumers’ access to information.
Lastly, Boiron misleads its consumers by manipulating their Health Care Professional Reviews webpage. The webpage has a total of three reviews, each one questionable and arguably biased. For example, Biljana Uzelac, who is introduced as a doctor for pediatric and family care, specializes in homeopathy and herbal medicine—although the webpage makes no reference to this specialization. On top of that, “she is a teaching professor at international [sic] Center for Development of Clinical Homeopathy” (Uzelac). Gary Kracoff, the second Oscillo reviewer, has a doctorate in naturopathic medicine and frequently likes homeopathic articles posted on LinkedIn, including content by Deborah Kelly, the director of public relations for Boiron USA. Boiron’s last Oscillo reviewer is Ken Redcross, whose LinkedIn bio explains that he embraces “alternative methods of healing in his practice.” He also lists Boiron as a project on his LinkedIn page, explaining that he wrote an article in its e-magazine to explain how to use homeopathic remedies for coughs. Clearly, each of these doctors carries an extreme bias toward alternative and homeopathic medicines like Oscillo. Along with this clear bias, it is also important to note that both Dr. Redcross and Dr. Kracoff were “compensated for [their] time by Boiron, the maker of Oscillo” (Oscillo). While Boiron’s review page may seem legitimate at first, the claims carry less weight once one considers the clear bias and compensation.
SCIENTIFIC PROOF THAT OSCILLOCOCCINUM IS INEFFECTIVE:
If the initial signs of dishonesty are not enough to repel consumers, science clearly uncovers Oscillo’s deception. A scientific examination reveals that homeopathy does not “wor[k] any better than placebo” (Ernst) and is simply a form of misinformation.
For example, scientific principles disprove Oscillo’s claims of effectiveness. For example, homeopathy’s Law of Infinitesimals asserts that dilution increases potency. This homeopathic philosophy posits that, “when sufficient water has been added to dilute the original substance away so that zero molecules remain,” the producer has found the most powerful medicine possible (Gavura). Looking at Oscillo's drug facts label, customers can find “Anas barbiae…..To reduce the duration and severity of flu-like symptoms, 200CK” on the box. 200CK is a homeopathic dilution. Buried in their website in complex language, Boiron describes this dilution abbreviation:
Korsakovian dilutions [use] ultra-purified water as the solvent, the machine removes 99% of the Mother Tincture and replaces it with the same volume of solvent. The vial is succussed for 10.5 seconds. The result is called 1CK. The 2CK is prepared identically from the 1CK. The automatic process using only 1 vial allows higher dilutions to be reached. (Oscillo)
In other words, the dilution ratio 200CK is equivalent to a dilution ratio of 10-400 in mathematical terms, making it “impossible that there is any of the original fermented goo in the final product. Yet you might not know any of that if you read the packaging” (Gavura). Oscillo dilutes its mislabeled “active ingredient” so much that there is absolutely no supposed remedy in the final sugar product that consumers purchase to cure their flu (see table 1).
Table 1
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Source: Scott Gavura, “Pharmacies continue to sell sugar pills a flu remedy,” Science-Based Medicine, 24 January 2019, sciencebasedmedicine.org/pharmacies-continue-to-sell-sugar-pills-as-flu-remedy/.
In addition to the fact that Oscillo has no active ingredient, scientific research shows that homeopathic medicines like Oscillococcinum are ineffective. For example, the National Health and Medical Research Council of Australia found results that suggest this medicine “was effective for zero of 68 illnesses.” More research in the United Kingdom even prompted “the National Health Service [to] stop funding its use” (Ernst). Scientifically examining Oscillo through mathematical equations, theoretical approaches, and research studies reveals that Oscillococcinum is an ineffective source of flu relief. Not only this, but Oscillo is simply a sugar pill with no active ingredient.
ETHICAL IMPLICATIONS:
Despite the facts, people seem to believe this medicine is truly effective. The product is so successful that 6,182 people awarded Oscillo five stars in their Amazon reviews, compared to just 252 one-star reviews.[3] Boiron’s nefarious marketing is successful; the company has swindled people with this sugar placebo for over 70 years, convincing them Oscillo is an effective alternative to real flu medication. This deception has enabled Boiron to flourish financially. For a product that “does not work [and] cannot work according to our scientific knowledge” (Gavura), Boiron has an impressively large following.
At first, Boiron’s trickery may seem only mildly harmful, but, upon further examination, the company is unethical. It fools people into buying an illegitimate solution to relieve their legitimate flu symptoms. On top of misleading its consumers with clever marketing and distorted information, it puts customers at risk. While the flu is generally an inconvenient illness that people can recover from in less than two weeks, it “can be life-threatening and result in death,” especially in adults “65 years and older”, as well as “children younger than 5 years” (CDC). Despite this, Oscillo is “recommended for ages 2 to 102” (Oscillo), which includes these high-risk age groups. In order to sell its sugar pills, Boiron also validates homeopathy as a reliable practice. Homeopathy—which is “used mostly to treat self-limiting conditions ranging from the common cold to allergies”—is sometimes used “for serious conditions like heart disease and cancer” (Ernst). Contributing to the belief that homeopathic philosophy can cure serious illness is immoral, especially when pharmacies already have other, more reliable treatments for these conditions. By deceiving its customers, putting people at risk, and supporting treatments not backed by science, Boiron actively engages in unethical behavior. As Mary Poppins once sang, “a spoonful of sugar helps the medicine go down,” but Boiron should not claim it can replace medicine itself.
Works Cited
“Can vitamin C prevent a cold?” Harvard Health Publishing, 13 October 2020, www.health.harvard.edu/cold-and-flu/can-vitamin-c-prevent-a-cold. Accessed 24 October 2020.
Ernst, Edzard. “Reject the pseudoscience of homeopathy.” Stat, 26 February 2016, www.statnews.com/2016/02/26/reject-pseudoscience-homeopathy/. Accessed 20 February 2019.
“FDA proposes new, risk-based enforcement priorities to protect consumers from potentially harmful, unproven homeopathic drugs” U.S. Food and Drug Administration, 17 December 2017, www.fda.gov/news-events/press-announcements/fda-proposes-new-risk-based-.... Accessed 24 October 2020.
Ferley, et al. “A Controlled Evaluation of a Homoeopathic Preparation in the Treatment of Influenza‐like Syndromes.” British Journal of Clinical Pharmacology, vol. 27, no. 3, 1989, pp. 329–335.
“Flu Symptoms and Complications.” Centers for Disease Control and Prevention, https://www.cdc.gov/flu/consumer/symptoms.htm. Accessed 25 February 2019.
Gavura, Scott. “Pharmacies continue to sell sugar pills a flu remedy.” Science-Based Medicine, 24 January 2019, sciencebasedmedicine.org/pharmacies-continue-to-sell-sugar-pills-as-flu-remedy/. Accessed 20 February 2019.
“Meet Our Staff.” Johnson Compounding and Wellness, http://www.naturalcompounder.com/about/meet-our-staff/. Accessed 20 February 2019.
Nienhuys, Jan. “The True Story of Oscillococcinum.” Homeowatch, 27 August 2003, www.homeowatch.org/history/oscillo.html. Accessed 20 February 2019.
Oscillo. Boiron Family of Medicines, www.oscillo.com. Accessed 20 February 2019.
Park, Robert. Superstition: Belief in the Age of Science. Princeton University Press, 2008.
Shermer, Michael. “Baloney Detection: how to draw boundaries between science and pseudoscience.” Michael Shermer, November 2001, michaelshermer.com/2001/11/baloney-detection/. Accessed 20 February 2019.
Uzelac, Biljana. “Meet the Doctor.” Green Pediatrics, greenpediatrics.com/meet-the-doctor/. Accessed 20 February 2019.
[1] Joseph Roy believed that a bacterium causes the influenza, but we now know that the flu is caused by a virus. In other words, his “like cures like” reasoning does not, in fact, follow homeopathic principles.
[2] Homeopathic goods have been distributed in the United States without FDA approval since 1988. In December of 2017, the FDA proposed new priorities for addressing this issue with plans to target homeopathic products that “have the greatest potential to cause risk to patients” (U.S. Food and Drug Administration).
[3] These numbers refer to Oscillo’s 30-dose box as of October 24, 2020.