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Turner L, Wang JC, Martinez JR, Najjar S, Rajapaksha Arachchilage T, Sahrai V. US businesses engaged in direct-to-consumer marketing of perinatal stem cell interventions following the Food and Drug Administration's enforcement discretion era. Cytotherapy 2024; 26:393-403. [PMID: 38340106 DOI: 10.1016/j.jcyt.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND AIMS The goal of this study was to analyze online marketing representations made by 300 US businesses selling allogeneic perinatal stem cell products. The study was conducted after a period of enforcement discretion by the US Food and Drug Administration (FDA). METHODS Data mining and content analysis were used to identify, analyze and categorize marketing claims made on the websites of 300 businesses selling perinatal stem cell interventions. RESULTS The study identified types of perinatal interventions companies advertised, geographic locations of clinics selling such products, types of companies operating in this space, diseases and injuries such businesses claim to treat, prices companies charge for such interventions, brand names of advertised perinatal cell products and identities of suppliers. CONCLUSIONS A substantial number of US businesses market unapproved perinatal stem cell products for various indications. This widespread commercial activity occurred following the conclusion of a period of enforcement discretion by the FDA and suggests the need for more robust and comprehensive regulatory responses to businesses selling unapproved perinatal stem cell products.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California Irvine, Irvine, California, USA; Department of Health, Society and Behavior, University of California Irvine, Irvine, California, USA; Sue and Bill Gross Stem Cell Research Center, University of California Irvine, Irvine, California, USA; Department of Family Medicine, University of California Irvine, Irvine, California, USA.
| | - Jia Chieng Wang
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | - Juan Ramon Martinez
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | - Shemms Najjar
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | | | - Victoria Sahrai
- Program in Public Health, University of California Irvine, Irvine, California, USA
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2
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Nishakanthi G. The Shortage of Malaysian Stem Cell Ethics in Mainstream Database: a Preliminary Study. Asian Bioeth Rev 2019; 11:437-460. [PMID: 33717327 DOI: 10.1007/s41649-019-00102-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/26/2019] [Accepted: 11/11/2019] [Indexed: 01/14/2023] Open
Abstract
Ethics is a philosophical branch of inquiry that reasons between what is right and wrong. The moral philosophy of Socrates, Aristotle, and Plato from ancient Greek became the basis of most of the western ethics. These days, ethics can be divided based on its inquiries for example, normative, descriptive, metaethics, and applied ethics or based on its theories like utilitarianism, emotivism, and universal ethics. In context with applied ethics that examines issues involving emerging technologies, this study will look into the ethics of Malaysian stem cell technology based on written literature. It was mainly to identify Malaysian literature on stem cell ethics through conventional search since the mainstream international database indicated an obvious shortage. The critical review of this literature will facilitate in the understanding of unique position of Malaysia towards stem cell and its ethics in reference to the limited number. Despite the limitation, this can be a preliminary study urging for more inquiries and exploration to fulfil the multiple perspectives in ethics such as the diversity of Malaysian ethics, the impact of ethics in stem cell regulation in Malaysia, and if western contemporary ethics influences Malaysian ethics particularly involving stem cell technology.
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3
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Snyder J, Turner L. Selling stem cell ‘treatments’ as research: prospective customer perspectives from crowdfunding campaigns. Regen Med 2018; 13:375-384. [DOI: 10.2217/rme-2018-0007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: To better understand how prospective customers interpret claims of businesses marketing unproven stem cell products that they are engaging in research activities. Materials & methods: The authors examined 408 crowdfunding campaigns for unproven stem cell interventions for references to research activities. Results: The authors identified three overarching themes: research as a signifier of scientific credibility; the experimental nature of stem cells as a rationale for noncoverage by insurers; and contributing to the advancement of science by engaging in research. Conclusion: The NIH, US FDA and others should be concerned about being co-opted to misrepresent the nature of these businesses’ activities. Efforts are also needed to better inform those considering purchasing unproven stem cell interventions about their relationship to legitimate research.
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Affiliation(s)
- Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Leigh Turner
- Center for Bioethics, University of Minnesota, N-302 Boyn HS, 410 Church Street SE, Minneapolis, MN 55455, USA
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Sipp D, Caulfield T, Kaye J, Barfoot J, Blackburn C, Chan S, De Luca M, Kent A, McCabe C, Munsie M, Sleeboom-Faulkner M, Sugarman J, van Zimmeren E, Zarzeczny A, Rasko JEJ. Marketing of unproven stem cell-based interventions: A call to action. Sci Transl Med 2018; 9:9/397/eaag0426. [PMID: 28679655 DOI: 10.1126/scitranslmed.aag0426] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 11/06/2016] [Accepted: 02/27/2017] [Indexed: 11/03/2022]
Abstract
Commercial promotion of unsupported therapeutic uses of stem cells is a global problem that has proven resistant to regulatory efforts. Here, we suggest a coordinated approach at the national and international levels focused on engagement, harmonization, and enforcement to reduce the risks associated with direct-to-consumer marketing of unproven stem cell treatments.
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Affiliation(s)
- Douglas Sipp
- Riken Center for Developmental Biology, 2-2-3 Minatojima Minamimachi, Kobe 650-0047, Japan. .,Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Global Initiatives, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Riken Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Timothy Caulfield
- Faculty of Law and School of Public Health, 461 Law Centre, University of Alberta, Edmonton, Alberta T6G 2H5, Canada.,Faculty of Law and School of Public Health, 461 Law Centre, University of Alberta, Edmonton, Alberta T6G 2H5, Canada
| | - Jane Kaye
- Department of Public Health, University of Oxford, Oxford, UK
| | - Jan Barfoot
- Medical Research Council Centre for Regenerative Medicine, School of Biological Sciences, University of Edinburgh, 5 Little France Drive, Edinburgh EH16 4UU, UK
| | - Clare Blackburn
- Medical Research Council Centre for Regenerative Medicine, School of Biological Sciences, University of Edinburgh, 5 Little France Drive, Edinburgh EH16 4UU, UK
| | - Sarah Chan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Nine Bioquarter, 9 Little France Road, Edinburgh EH16 4UX, UK
| | - Michele De Luca
- Center for Regenerative Medicine "Stefano Ferrari," Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Gottardi 100, 41125 Modena, Italy
| | - Alastair Kent
- Genetic Alliance UK, Level 3 Barclay House, 37 Queen Square, London WC1N 3BH, UK
| | - Christopher McCabe
- Department of Emergency Medicine, University of Alberta, Edmonton, Canada
| | - Megan Munsie
- Centre for Stem Cell Systems, Department of Anatomy and Neuroscience, School of Biomedical Science, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Level 2, Kenneth Myer Building, 30 Royal Parade Parkville, 3010 Victoria, Australia.,Education, Ethics, Law and Community Awareness Unit, Stem Cells Australia, University of Melbourne, Level 2, Kenneth Myer Building, 30 Royal Parade Parkville, 3010 Victoria, Australia
| | | | - Jeremy Sugarman
- Berman Institute of Bioethics and Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Esther van Zimmeren
- University of Antwerp, Faculty of Law, Research Group Government and Law, Venusstraat 23, 2000 Antwerp, Belgium
| | - Amy Zarzeczny
- Johnson Shoyama Graduate School of Public Policy, University of Regina, 110-2 Research Drive, Regina, Saskatchewan S4S 7H1, Canada
| | - John E J Rasko
- Sydney Medical School, University of Sydney, Sydney, Australia. .,Gene and Stem Cell Therapy Program, Centenary Institute, Sydney, Australia.,Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital, Level 2, Building 89, Missenden Road, Camperdown, New South Wales 2050, Australia
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5
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Abstract
Clinical application of autologous cells by businesses promoting unproven stem cell treatments represents the largest growth sector in this problematic industry, but also presents special challenges to regulators. Patients frequently identify autologous cells as personal property, using the language of 'ownership'. Through an analysis of comments submitted to the US FDA in 2016 in response to recent draft guidance documents, I show that a sense of ownership and identity in autologous cells is consistently expressed by stakeholders. In the USA and other countries, regulation of cell and tissue biologics as 'drugs' relies substantially on whether a given product has been modified in ways that alter its biological properties, which has direct implications for property and ownership rights. Competing views on property rights in 'natural' and modified autologous cells have profound implications for the future of regulation of marketed autologous cells.
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Affiliation(s)
- Douglas Sipp
- RIKEN Center for Developmental Biology, Kobe 651-1212, Japan.,Keio University School of Medicine, Department of Physiology, Tokyo 160-8582, Japan.,Keio Global Research Initiative, Tokyo 160-8582, Japan.,RIKEN Center for Advanced Intelligence Project, Tokyo 103-0027, Japan
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6
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Tanner C, Petersen A, Munsie M. ‘No one here's helping me, what do you do?’: addressing patient need for support and advice about stem cell treatments. Regen Med 2017; 12:791-801. [DOI: 10.2217/rme-2017-0056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: This article examines how those who contemplate purported stem cell treatments (SCTs) negotiate available information sources and the adequacy of current approaches to guidance and support. Materials & methods: Qualitative interviews undertaken with people who had contemplated or undergone purported SCTs for a range of conditions (n = 24 and n = 27, respectively), as well as professionals who are frequently asked about SCTs (n = 20) were analyzed. Results: Our findings reveal the difficulties for individuals in discriminating between different sources of information on SCTs and the limitations of current responses. Conclusion: In the context of contending information about SCTs informal (‘accidental’) advisors potentially play a crucial role in supporting patients. Additional approaches are also required to better address patients’ needs.
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Affiliation(s)
- Claire Tanner
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Alan Petersen
- Sociology, School of Social Sciences, Monash University, Clayton, Victoria, Australia
| | - Megan Munsie
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
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7
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Martinho AM, Turner L. Stem cells in court: historical trends in US legal cases related to stem cells. Regen Med 2017. [DOI: 10.2217/rme-2017-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Using two legal research platforms, we identified 193 stem-cell-related legal cases that were decided in US courts. Classifying the cases by category, we examined historical trends in the types of legal cases related to stem cells. Major types of cases involved plaintiffs seeking to overturn denial of health insurance coverage decisions, disputes related to intellectual property, false advertising, breaches of contract, exposure to hazardous agents, regulatory decisions, stem cell procedures and professional standard of care, use of stems cells in research, and public funding of embryonic stem cell research. Analysis of court decisions provides insight into contemporary and historical legal issues related to stem cells and reveals the breadth of stem-cell-related cases now being decided by US courts.
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Affiliation(s)
| | - Leigh Turner
- CVS Health, 2211 Sanders Rd, Northbrook, IL 60062, USA
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O'Donnell L, Turner L, Levine AD. Part 6: The role of communication in better understanding unproven cellular therapies. Cytotherapy 2016; 18:143-8. [PMID: 26719207 DOI: 10.1016/j.jcyt.2015.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/03/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Lynn O'Donnell
- Division of Hematology, Cell Therapy Laboratory, The Ohio State University, Columbus, Ohio, USA, International Society for Cellular Therapy (ISCT) Global Secretary 2013-2016, Editor in Chief of Telegraft
| | - Leigh Turner
- University of Minnesota Center for Bioethics and School of Public Health, Minneapolis, Minnesota, USA, Member at Large of the ISCT Presidential Task Force on the Use of Unproven Cellular Therapies
| | - Aaron D Levine
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA, Member at large of the ISCT Presidential Task Force on the Use of Unproven Cellular Therapies.
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9
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Sipp D. Direct-to-consumer stem cell marketing and regulatory responses. Stem Cells Transl Med 2013; 2:638-40. [PMID: 23934911 DOI: 10.5966/sctm.2013-0040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is a large, poorly regulated international market of putative stem cell products, including transplants of processed autologous stem cells from various tissues, cell processing devices, cosmetics, and nutritional supplements. Despite the absence of rigorous scientific research in the form of randomized clinical trials to support the routine use of such products, the market appears to be growing and diversifying. Very few stem cell biologics have passed regulatory scrutiny, and authorities in many countries, including the United States, have begun to step up their enforcement activities to protect patients and the integrity of health care markets.
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Affiliation(s)
- Douglas Sipp
- RIKEN Center for Developmental Biology, Kobe, Japan.
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Levine AD. Improving oversight of innovative medical interventions in Texas, USA. Regen Med 2012; 7:451-3. [DOI: 10.2217/rme.12.43] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Aaron D Levine
- School of Public Policy, Georgia Institute of Technology, 685 Cherry Street, Atlanta, GA 30332-0345, USA
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Levine AD, Wolf LE. The roles and responsibilities of physicians in patients' decisions about unproven stem cell therapies. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2012; 40:122-134. [PMID: 22458467 DOI: 10.1111/j.1748-720x.2012.00650.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Capitalizing on the hype surrounding stem cell research, numerous clinics around the world offer "stem cell therapies" for a variety of medical conditions. Despite questions about the safety and efficacy of these interventions, anecdotal evidence suggests a relatively large number of patients are traveling to receive these unproven treatments - a practice called "stem cell tourism." Because these unproven treatments pose risks to individual patients and to legitimate translational stem cell research, stem cell tourism has generated substantial policy concern and inspired attempts to reduce these risks through the development of guidelines for patients and medical practitioners. This paper examines the roles and responsibilities of physicians in patients' home countries with respect to patients' decisions to try unproven stem cell therapies abroad. Specifically, it examines professional guidance from two organizations - the American Medical Association and the International Society for Stem Cell Research - and assesses physicians' professional and legal obligations to patients considering unproven stem cell therapies. Then, drawing on qualitative interviews conducted with patients who traveled abroad for unproven stem cell treatments, it explores the roles that physicians actually play in patients' decisions and compares these actual roles with their professional and legal responsibilities. The paper concludes with a discussion of strategies to help improve the guidance physicians provide to patients considering unproven treatments.
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12
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Sipp D. The unregulated commercialization of stem cell treatments: a global perspective. Front Med 2011; 5:348-55. [PMID: 21964637 DOI: 10.1007/s11684-011-0150-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 07/14/2011] [Indexed: 11/27/2022]
Abstract
Research into the biological properties and clinical potential of stem cells has spurred strong public investment, industry development, media coverage, and patient interest in recent years. To date, however, few clinical applications of demonstrated safety and efficacy have been developed with the exception of uses of hematopoietic stem cells in the treatment of diseases of the blood and immune systems. This lack of an evidence basis notwithstanding, hundreds of companies and private clinics around the world now sell putative stem cell treatments for an enormously broad range of medical and quality-of-life conditions. This represents a major challenge for legitimate scientists working in the field, for authorities seeking to protect their constituencies, and for patients and consumers targeted by such companies' marketing strategies. In this review, I provide an overview of the global industry in pseudomedical stem cell treatments, with an investigation of claims in a single disease area (amyotrophic lateral sclerosis), and make recommendations for the introduction and enforcement of appropriate regulatory responses to this problem.
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Affiliation(s)
- Douglas Sipp
- Research Unit for Science Policy and Ethics Studies, RIKEN Center for Developmental Biology, 2-2-3 Minatojima Minamimachi, Chuo-ku, Kobe 650-0047, Japan.
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