Complementary and Alternative Medicine Costs – a Systematic Literature Review

Abstract

Objective: The aim of this literature review, performed within the framework of the Swiss governmental Program of Evaluation of Complementary Medicine (PEK), was to investigate costs of complementary and alternative medicine (CAM). Materials and Methods: A systematic literature search was conducted in 11 electronic databases. All retrieved titles and reference lists were also hand-searched. Results: 38 publications were found: 23 on CAM of various definitions (medical and non-medical practitioners, over-the-counter products), 13 on homeopathy, 2 on phytotherapy. Studies investigated different kinds of costs (direct or indirect) and used different methods (prospective or retrospective questionnaires, data analyses, cost-effectiveness models). Most studies report ‘out of pocket’ costs, because CAM is usually not covered by health insurance. Costs per CAM-treatment / patient / month were AUD 7-66, CAD 250 and GBP 13.62 ± 1.61. Costs per treatment were EUR 205 (range: 15-1,278), USD 414 ± 269 and USD 1,127. In two analyses phytotherapy proved to be cost-effective. One study revealed a reduction of 1.5 days of absenteeism from work in the CAM group compared to conventionally treated patients. Another study, performed by a health insurance company reported a slight increase in direct costs for CAM. Costs for CAM covered by insurance companies amounted to approximately 0.2-0.5% of the total healthcare budget (Switzerland, 2003). Publications had several limitations, e.g. efficacy of therapies was rarely reported. As compared to conventional patients, CAM patients tend to cause lower costs. Conclusion: Results suggest lower costs for CAM than for conventional patients, but the limited methodological quality lowers the significance of the available data. Further well-designed studies and models are required.

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

“…[11][12][13][14][15][16][17][18][19][20][21][22][23] Five of these prior reviews attempted to capture all economic evaluations of CIM therapies across all conditions. 11 19-21 23 However, it is unclear as to whether all or even the majority of economic evaluations of CIM have been identified by these reviews.…”

Models for the Study of Whole Systems

“…Data indicate greater safety ("side effects" are part of the complete picture of outcomes from a complex systems perspective) as well as sometimes shorter acute illnesses and lower costs for certain CAM therapies, including homeopathy, compared with conventional drugs in noncancer conditions. 60,61,63,[108][109][110] Finally, it is beyond the scope of this article to discuss the macro-entanglement model for CAM clinical research, which has received extensive coverage elsewhere 103,[111][112][113][114][115][116][117] Nonetheless, it is important to acknowledge that entanglement is an emergent phenomenon in the behavior of closed systems in quantum mechanics. However, it is possible, but not essential, to invoke macro-entanglement concepts to apply the complex systems thinking outlined in the present article.…”

Prophylactic Role for Complementary and Alternative Medicine in Perinatal Programming of Adult Health

“…Mothers also report that they perceive there are relatively less side effects associated with CAM therapies compared to routine drug therapies [46,47] and prefer such approaches over psychotherapy techniques, which do not always result in longterm improvements [48]. From a public health perspective, given the same effectiveness, CAM can also reduce the medical expense as it is less expensive compared to conventional medicine, including psychotherapy techniques [49]. Furthermore, CAM can reduce the need for administration of conventional drugs, leading to decreased drug costs, and a decrease in the risk of side effects associated with drug administration.…”