Comparison of Swiss Basic Health Insurance Costs of Complementary and Conventional Medicine

Abstract

Background: From 1999 to 2005, 5 methods of complementary and alternative medicine (CAM) applied by physicians were provisionally included into mandatory Swiss basic health insurance. Between 2012 and 2017, this will be the case again. Within this process, an evaluation of cost-effectiveness is required. The goal of this study is to compare practice costs of physicians applying CAM with those of physicians applying solely conventional medicine (COM). Methods: The study was designed as a cross-sectional investigation of claims data of mandatory health insurance. For the years 2002 and 2003, practice costs of 562 primary care physicians with and without a certificate for CAM were analyzed and compared with patient-reported outcomes. Linear models were used to obtain estimates of practice costs controlling for different patient populations and structural characteristics of practices across CAM and COM. Results: Statistical procedures show similar total practice costs for CAM and COM, with the exception of homeopathy with 15.4% lower costs than COM. Furthermore, there were significant differences between CAM and COM in cost structure especially for the ratio between costs for consultations and costs for medication at the expense of basic health insurance. Patients reported better quality of the patient-physician relationship and fewer adverse side effects in CAM; higher cost-effectiveness for CAM can be deduced from this perspective. Conclusion: This study uses a health system perspective and demonstrates at least equal or better cost-effectiveness of CAM in the setting of Swiss ambulatory care. CAM can therefore be seen as a valid complement to COM within Swiss health care.

Complementary and Alternative Medicine Provision in Europe – First Results Approaching Reality in an Unclear Field of Practices

“…Teaching and certification are managed by regional or national regulations. Due to a lack of commercial interest there are very limited data and public funding for research, so we understand little about the provision, outcome and the social and economic impact of CAM [35]. It is estimated that the CAM market, in total, amounts to approximately 1% of EU GPs [36].…”

“…Various types of CAM schools have been maintained by the respective organisations, with curricula ranging from existing international standards down to a local introductory level, not always recognised by the national CAM body. For non-medically trained practitioners there is a single study, conducted 1980/81 in the UK, which showed that half of the practitioners have had formal education [35].…”

Emerging Economies' Need for Cheap, Efficient Health Care Makes Western Anti-Homeopathy Rhetoric Irrelevant: Observations from the Canadian Homeopathy Conference, October 2011

“…Indeed, the homeopathic ''heresy'' is even managing to infiltrate closer to home, in the form of a groundbreaking report commissioned by the government of Switzerland affirming the cost effectiveness of several forms of CAM as equivalent to conventional medicine, except for one: ''Statistical procedures show similar total practice costs for CAM and COM [conventional medicine], with the exception of homeopathy with 15.4% lower costs than COM'' [authors' emphasis]. 26 One is tempted to think it is merely a matter of time before cash-strapped Western governments struggling with skyrocketing conventional health care costs take notice. In the West, homeopaths feel they have their backs to the wall.…”

Von «Kreml-Methoden» zum «Vertrauensprinzip»: 15 Jahre WZW-Kontroverse zum Verbleib der ärztlichen Komplementärmedizin in der sozialen Grundversicherung der Schweiz

“…Zur Zweckmässigkeit sind Sicherheit und Patientenkongruenz sogar sehr gut dokumentiert. Hinsichtlich der Wirtschaftlichkeit wird ein tendenziell kostengünstiges Kostenprofil ausgewiesen und zudem belegt, dass auch die additive Nutzung (gleichzeitige Inanspruchnahme anderer Ärzte) nicht höher ist als in der konventionellen Schulmedizin [9,10]. Im aktuellen ambulanten Tarif (Tarmed) ist für die Komplementärmedizin ausschliesslich der Zeitaufwand abgebildet, welcher indessen nicht höher dotiert ist; durch eine Limitatio auf maximal 180 min pro 6 Monate wird zudem einer «Mengenausweitung» vorgebeugt.…”