Consumer Views on the Role of the Natural Health Products (NHPs) Industry in Pharmacovigilance for NHPs: A Qualitative Study in New Zealand

Pharmacovigilance (safety monitoring) for natural health products (NHPs) is essential for consumer health protection. However, pharmacovigilance for NHPs is under-researched, especially regarding consumer involvement and the contributions of the NHPs industry. This qualitative study aimed to explore consumers’ views, experiences, and awareness of the NHPs industry’s contributions to pharmacovigilance for NHPs in New Zealand. One-on-one online interviews were conducted with NHP consumers (n = 19) using a semi-structured interview schedule with the following domains: (1) meaning of terms (NHPs and pharmacovigilance); (2) pharmacovigilance for NHPs (including experiences with reporting adverse drug reactions (ADRs) to the NHPs industry); (3) views on NHP regulations and pharmacovigilance regulatory requirements for the NHPs industry; (4) a proposed active surveillance study for NHPs. Interviews were recorded, transcribed verbatim, and analysed inductively. Five main themes were identified: (1) right to choose; (2) trust enables engagement; (3) considering information; (4) rationalising consumer protection; (5) perceiving and navigating risk. Participants exercised autonomy to self-select NHPs. Participants had limited experience with ADRs (associated with NHP use) and with reporting ADRs to the NHPs industry. Despite acknowledging that ethical standards varied across companies, participants expressed distrust of the industry’s handling of ADRs, due to perceived conflicts of interest and a lack of transparency. Participants’ self-responsibility, underscored by autonomy and lack of trust in the industry, appeared to be significant barriers to the industry’s involvement in pharmacovigilance for NHPs. Despite low awareness of NHP regulations, participants held expectations for regulatory requirements that balance product accessibility and safety controls. Participants (consumers of NHPs) had minimal engagement with the NHPs industry regarding pharmacovigilance. Raising awareness of the potential harms associated with NHP use, improving knowledge of channels for reporting ADRs, and fostering trust in the industry’s handling of ADR reports could empower consumers and enable the industry to assume a more active and significant role in pharmacovigilance for NHPs. Quantitative studies involving larger samples of NHP consumers are necessary to corroborate these findings. Safety monitoring (i.e., pharmacovigilance) for natural health products (NHPs) is essential for consumer health protection. Companies that manufacture and market NHPs are key stakeholders in monitoring the safety of their products, alongside consumers, health professionals, regulators, and natural-health practitioners. Online interviews were conducted with 19 NHP consumers to explore their experiences with and views on the involvement of NHP companies with pharmacovigilance for NHPs, and related regulations for NHPs, in New Zealand. Many participants reported self-selecting NHPs without health professional oversight. Participants had limited experience with adverse reactions associated with NHP use and with reporting these to NHP companies. Participants often do not, or would not, report adverse reactions to NHP companies. This may be because some participants feel personally responsible for using NHPs and doubt that NHP companies would handle such reports responsibly. Despite having low awareness of existing regulations for NHPs, participants expressed support for regulations that safeguard consumer rights and safety, enable informed purchasing decisions, and maintain consumer right to choose and access products. Public health strategies to encourage consumers to report adverse reactions and enable NHP companies to play a greater role in pharmacovigilance should focus on increasing understanding about the potential risks associated with NHPs use, raising awareness of adverse reaction reporting, and supporting NHP companies in building trust and transparency in handling adverse reaction reports. Surveys involving more people are needed to examine whether these interview findings reflect the views of New Zealand consumers more broadly.