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But there is no study in any established journal that proves RSI's products achieve many of the treatment and prevention benefits claimed by distributors and the company's promotional materials, says Stephen Barrett, a retired physician who heads Quackwatch, an Allentown, Pennsylvania-based group that scrutinizes alternative health claims. Nor does any study in any of these journals show that RSI products are better than those offered by other companies or in supermarkets and drugstores. And research has been inconclusive about whether ingesting antioxidants in pills produces the proven benefits of simply eating more antioxidant-rich fruits and vegetables.
Homeopathic remedies also lack scientific support. These remedies are based on the unfounded theory that infinitesimally tiny amounts of offending substances -- on the order of one part in several million -- immunize the body against disease. Critics say that homeopathic remedies are nothing more than inert placebos that may help patients only by fooling them into thinking they've received an effective treatment. Over many years, researchers have found that about 30 percent of patients who receive placebos report improvement in their medical condition.
"You don't even know what's in dietary supplement bottles, let alone whether they are helpful for anything, because these products are completely unregulated," says Dr.Marcia Angell, executive editor of the New England Journal of Medicine. That's because a controversial 1994 law, pushed through Congress by the powerful dietary supplement industry, exempted supplements from FDA testing as long as manufacturers don't claim that their products cure, treat, or prevent disease. Angell cowrote a scathing editorial last year urging that supplements be subjected to the same rigorous testing required for conventional drugs. "For doctors to sell products for which no one knows the safety and efficacy seems wrong and unethical," she says.
Another ethical problem is that doctors hawking RSI products are steering patients toward supplements that cost more than similar products available in retail stores, says Lisa Colodny, pharmacy services coordinator at Broward General Medical Center. For instance, RSI's BioC, a combination of vitamin C and bioflavonoids, costs $33.25 for 150 tablets while a similar product made by Lindberg, with most of the same ingredients and a higher dose of ascorbic acid, costs $4.20 for 100 tablets at Eckerd. In another example, RSI boxes 60 BioC tablets with 60 tablets of a multivitamin/protein combination in a package called Cellular Essentials, which costs $59.95. But if you go to Eckerd and buy a comparable multivitamin called TheragranM, along with Lindberg's C vitamin and Turbo protein tablets, you get a combination similar to Cellular Essentials, with a lot more pills, for only $28.98.
"I do think antioxidant therapy [vitamins C, E, and beta-carotene] can be beneficial," says Colodny, who compared products and prices for New Times. "But do I think that the particular Rexall therapy is the best one? Not necessarily, especially when you look at the prices."
Gold said that his company's products are more scientifically designed and of higher quality than those of other firms. But there is another explanation for the higher prices. Rexall Sundown's 10K report states that there is a higher profit margin on RSI products than on goods sold by the company's retail divisions. Commissions paid to RSI distributors account for most of the division's administrative and sales expenses, and RSI has higher overhead costs than Rexall's other units, the report adds. According to Sylvain Chevalier, a Miami-based RSI distributor, 60percent of the company's revenues are paid back to distributors in commissions. Thus the high cost of paying commissions to tens of thousands of network-marketing middlemen helps to explain why patients seeking dietary supplements can get a better buy at Eckerd.
But patients aren't the only potential losers. Critics say doctors and others who become Rexall Showcase distributors may be falling victim to a classic, though well-disguised, pyramid scheme.
Earlier this month, 44 prosperous-looking, middle-aged people crowded into a monthly distributors' meeting at the Holiday Inn off I95 in Hollywood. At least three doctors were in the narrow room, which buzzed with excited conversation beforehand. Schuman of Boca Raton, a head-and-neck surgeon, boasted to a clot of people in the hallway that his wife's RSI business had brought in enough income to allow him to sell his practice and teach medicine abroad. Dr.Rodney Cohen, a Boca gastroenterologist, told a visitor that he hopes his wife's RSI business grows enough so that he can follow in Schuman's steps and scale back his medical practice.
The host was Chevalier, a handsome, debonair French-Canadian who had recruited many of the distributors at the meeting and who specializes in signing up doctors. Standing before a slide-projection screen, Chevalier disclaimed any skill at salesmanship but proceeded to prove the opposite. "I'm the messenger of good news," he said. "How many people in this room would like to have more money and more time?" People smiled and raised their hands. He described how he'd replaced his six-figure income as an international banker with his income from RSI while enjoying the comforts of working at home. A slide he showed listed the average income of RSI distributors who have recruited five levels of active distributors, or downliners, as $21,867 amonth.
"Everyone knows and trusts Rexall, a great American institution we all grew up with," he said. "It's a family of companies that still includes thousands of Rexall drug stores," he added, inaccurately. "We're at the right place and the right time. How many of you have missed a great business opportunity before?" A number of hands went up. "If you miss this, you'll remember it for the rest of your life." He then introduced Gold, who described the compensation plan for distributors as the "most lucrative" in the network-marketing industry. "We have the most elite professional distributors in the industry, because great people attract great people," Gold boasted.