Japan and Australia’s online market for unproven stem cell treatments

A growing number of clinics in Australia and Japan are taking advantage of the permissive stance of regulatory bodies with respect to the use of the patient’s own cells, so called autologous therapies, to offer unproven treatments to patients. Examining the websites of these clinics reveals common trends and differences between the claimed stem cell treatments, methods and uses in Japan and Australia, as well as the marketing approaches being used to attract customers.

What background and points are discussed?

Dr Munsie and colleagues searched the Internet to compile a list of 88 locations in Japan and 70 locations in Australia offering unproven autologous SC treatments from hospitals and private clinics. The authors’ analysis of these websites shows that SC treatments in Japan are primarily marketed for cosmetic purposes, followed by anti-aging, hair loss and heart conditions. In Australia treatments are primarily marketed for treating joint, tendon and ligament problems (orthopaedic purposes), followed by cosmetic, anti-aging and nervous system applications. The authors note that 83% of the clinics in Japan in contrast to 37% of the clinics in Australia offer strictly cosmetic therapies. The most common cosmetic uses are for breast enhancement in Japan and skin ‘rejuvenation’ in Australia. Most clinics in both Japan (73%) and Australia (80%) claim SCs are prepared from patient fat tissue. Blood and bone marrow are less common sources of SCs, but are sometimes used in combination with fat-derived SCs. Treatments are predominately administered by injection, but many websites don’t say where. For both countries where more detail was provided, about ~40% describe injections as being into the blood stream and in Australia, about one quarter discuss injections directly into a patient’s joint.

Dr Munsie and her colleagues also detail how clinics’ therapies are promoted on websites, specifically noting how clinics legitimise their services and discuss the effectiveness and safety of treatments. All businesses attempt to build credibility by emphasising the ‘scientific’ basis of their therapies. Often this is done by relating therapies to external studies or by making broad statements about the promising advancements of SC research. However, very few clinics from either country display examples of publications in peer-reviewed journals that they were directly part of. Proclamations that clinics’ treatments are safe and effective are another common trend, however a small number of clinics do have disclaimers stating that results cannot be guaranteed. Many clinics highlight the experience and credentials of their doctors, but Australian clinics appear to take this further by describing doctors as specialised stem cell practitioners. Listing doctors' memberships to professional associations is also a common trend used to build credibility. Notably, many of these associations support reducing regulatory oversight and oppose approving treatments through clinical trials. Testimonials by grateful patients and endorsements by celebrities appear on several websites despite codes of conduct and/or regulations than ban the use of testimonials in medical marketing. Finally, the vast majority of clinics substantiate their work by referring to various kinds of certifications. For example, some clinics associate themselves with laboratories that are ‘accredited’ by a government agency or comment that they use equipment that is certified in some way. Particularly of interest is that several clinics (3 in Japan and 2 in Australia) are currently registered to conduct clinical trials and list their registration numbers on their website, but they provide little information on what the trial is and how the clinic is involved. These clinics appear to sell the treatments in clinical trials to patients regardless of if they are eligible for the trial or wish to participate in it.