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.