Positive Health Online

Abstract

White and Ernst, Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, Exeter, UK. a.r.white@ex.ac.uk systematically reviewed economic analysis of complementary medicine .

Background

Methodology

Searches were performed in Medline, Embase and AMED for reports of cost description, cost comparison, cost effectiveness, or cost benefit studies. Prospective studies that investigated comparative groups were considered to be of higher quality.

Results

A total of 34 reports were included. Retrospective studies in which a range of therapies are provided in primary care suggest that these may reduce referral and treatment costs, but prospective studies suggest that complementary medicine is an additional expense and does not substitute for orthodox care. For individual therapies, one thorough but retrospective study suggests that carefully targeted acupuncture may reduce referral costs for musculo-skeletal problems . One large pragmatic study of spinal manipulative therapy suggests that this treatment may reduce the societal costs of back pain, but four controlled trials found that manipulative therapy does not reduce the costs incurred by the back pain patients themselves or by their health insurance provider.

Conclusion

Spinal manipulative therapy for back pain may offer cost savings to society, but it does not save money for the purchaser . There is a paucity of rigorous studies that could provide conclusive evidence of differences in costs and outcomes between other complementary therapies and orthodox medicine. The evidence from methodologically flawed studies is contradicted by more rigorous studies, and there is a need for high quality investigations of the costs and benefits of complementary medicine .

References

White AR and Ernst E. Economic analysis of complementary medicine: a systematic review. Complementary Therapies in Medicine 8(2): 111-8. Jun 2000.