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By DANIEL TAUB

Staff Reporter

A Rite Aid drugstore or Ralphs supermarket sells a bottle of 100 vitamin E pills for as little as $5 even less if it’s being discounted. But drive down the street to a Whole Foods Market or a health-food store specializing in nutritional supplements, and a bottle of 100 vitamin E tablets could easily run well over $25.

Vitamin E is hardly the only product for which huge price discrepancies exist. A bottle of multivitamins, ginkgo biloba, echinacea or St. John’s wort often can be found just a shelf away from another that appears identical but is many times the price.

It’s all part of the confounding world of pricing for natural vitamins, minerals and herbal remedies. Because the industry is unregulated and because the market is dominated by small companies, there is no standard for how much a particular item should cost.

“There are a lot of shenanigans that get played in this industry and unfortunately the people who end up getting duped are the consumers,” said Rick Liva, a family physician who specializes in natural medicine and owner of natural medicine firm RHG & Co. Inc. in Middletown, Conn.

Sometimes, however, there is an explanation for the variances “a reasonable explanation,” noted Ken Babal, staff nutritionist for Erewhon, a natural foods market in the Fairfax district.

In the case of vitamin E, Babal said, the bottle found at Rite Aid or Ralphs for just a few dollars is likely synthetic that is, made in a laboratory. The $25-or-more bottle found in a health-food store is likely filled with tablets containing vitamin E that have been naturally extracted from soybeans.

Similarly, two bottles that appear to contain the same substance actually may be different products. For example, there’s a wide price variance for different ginkgo biloba brands because one product may contain powdered leaves from the plant, while another may contain an actual extract from the herb. That extract has more of the ingredients that are believed to be beneficial.

The extract “may be 50 times the concentration,” Babal said. “Usually you can take fewer pills, too, with the extract, even though it is two or three times the price.”

Liva said the varying concentrations may make the difference between a product being effective and it being a waste of money.

In the case of ginkgo biloba, which is thought to help people with short-term memory problems, clinical tests conducted in Europe involved a standardized extract with set amounts of the plant’s two active substances, Liva said. The benefits associated with ginkgo, therefore, are only associated with use of the standardized extract not with the less-expensive powdered plant leaves.

If the product is not an extract, Liva said, it may not even be made from the right species of the ginkgo plant. “Unless (the product’s manufacturer is) telling absolutely the truth about what you have in there, it’s hard for people to differentiate,” he said.

Because the Food and Drug Administration does not regulate natural health remedies as it does pharmaceuticals, knowing for sure what a certain product contains is not easy. Federal Trade Commission regulations prohibit misleading labeling, but in the case of ginkgo biloba, accurate labeling does not guarantee that consumers are getting what they expect.

Typically, the most effective vitamins, minerals and herbs are the most expensive, because the extra cost is associated with better ingredients and more-stringent testing.

“You have to be aware that even in the herbal area, there is a correlation between the price and the efficacy,” said Dennis Jolicoeur, chief financial officer of Chatsworth-based Natrol Inc., a maker of vitamins and herbal supplements.

None of that, however, explains why many natural medications are just as expensive as traditional medicine despite the fact they do not require millions of dollars of testing and federal government approvals, as do prescription drugs.

Liva attributed the high price to successive markups on vitamins and herb extracts as they go through distribution channels. Product manufacturers typically apply a 100 percent to 200 percent markup from the raw materials, then the distributors put a 20 percent to 40 percent markup on top of that. Finally, retailers attach a markup of another 100 percent.

Pharmaceutical companies, by comparison, often sell directly to drugstore chains. Being much larger than vitamin and herb companies, pharmaceutical manufacturers can also buy their raw materials in much larger quantities, thus keeping top-line costs contained.

While manufacturers of natural remedies are only responsible for a portion of the markups, they are by far the industry’s biggest money makers, said John Weeks, publisher and editor of The Integrator, a monthly newsletter on alternative medicine.

“They’re the deepest pockets,” he said. “From a basic economic perspective, if you’re an alternative medical school and you’re looking for funding support, your source is most likely going to be natural products suppliers.”