A survey on availability and composition of herbal products with beneficial health claims for chronic non-communicable diseases in Sri Lanka.

BACKGROUND: Herbal medicinal products are becoming increasingly available worldwide. Most countries lack stringent guidelines for the regulation of herbal medicinal products. This study aimed to assess the availability and affordability of herbal products for non-communicable diseases (NCDs), as well as their compositions and health claims, in a developing country. METHODS: A cross-sectional survey was conducted by visiting 41 commercial outlets, including supermarkets, community pharmacies, and Ayurveda stores between August and September 2023. A total of 88 products were selected, and assessed for their ingredients, compositions, health claims, and other key labelling information. Availability of each product was recorded across the three types of commercial outlets. Affordability of herbal products was determined based on the minimum wage of an unskilled government worker in Sri Lanka. RESULTS: Majority of the products were available at Ayurveda stores (n = 66, 73.9%), followed by supermarkets (n = 65, 73.9%) and pharmacies (n = 50, 63.1%). The most common active ingredient identified was Camellia sinensis (L.) Kuntze (n = 19, 21.6%). None of the locally manufactured herbal products mentioned the composition of their ingredients. Some products had inaccurate label information, such as misspellings and duplications of scientific names for plants (n = 4, 4.5%). Many products lacked essential label information, such as side-effects (n = 79, 89.8%), warnings (n = 71, 80.7%) and contraindications (n = 69, 78.4%), special patient group information (n = 63, 71.6%), storage conditions (n = 57, 64.7%), Department of Ayurveda registration number of the product (n = 16, 18.2%), and Department of Ayurveda registration number of the manufacturer (n = 69, 78.4%). The affordability of the majority of herbal products (68.9%) was low. CONCLUSION: Despite the higher availability of herbal products, the low affordability and misleading label information are a concern. Herbal products are often marketed with unsubstantiated health claims which can mislead consumers. Therefore, there is a need for stringent regulations to ensure the efficacy, safety, and quality profiles of herbal medicinal products in Sri Lanka.