Economic evaluations

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With the annual NHS budget now in excess of £90 billion,[1] cost-effectiveness is an extremely important issue. The National Institute for Clinical Excellence (NICE) – responsible for deciding which treatments should be provided by the NHS – has to weigh up the benefits offered by a particular treatment against the costs of that treatment. NICE does not accept or reject interventions on cost effectiveness grounds alone,[2] but it is undoubtedly a major deciding factor.[3] The following studies demonstrate that treatment by a homeopath is a cost-effective option for the NHS.

Topics covered on this page include:

Measuring cost-effectiveness

Treatment by a homeopath can achieve better outcomes for similar or lower costs

A German study involving 493 patients seen in general practice found that treatment by a homeopath gave better outcomes than conventional treatment for similar costs[4]

  • This study published in 2005 was commissioned by a German health insurance company to see whether they should continue to cover homeopathic treatment. The outcomes and costs of homeopathic and conventional treatment were compared in patients being treated for chronic conditions commonly seen in general practice. These included headache, low back pain, depression, insomnia and sinusitis in adults, and atopic dermatitis, allergic rhinitis and asthma in children.
  • Limitations of the study: This study was non-randomised meaning that the patients decided whether they wanted homeopathic or conventional treatment; although this reflects real life, critics would say that there may be differences between the people tending to choose each treatment which could influence the results.
  • Witt C, Keil T, Selim D, et al. Outcome and costs of homeopathic and conventional treatment strategies: a comparative cohort study in patients with chronic disorders. Complement Ther Med 2005; 13: 79-86 http://www.ncbi.nlm.nih.gov/pubmed?term=16036164

In a study involving 499 children aged 18mths to 4 years, homeopathic treatment was found to be more medically effective and cost-effective than antibiotics in the treatment of recurrent upper respiratory tract infections[5]

  • This French study compared homeopathic and conventional treatment of recurrent acute rhinopharyngitis. Homeopathic treatment gave significantly better results than antibiotics in terms of medical effectiveness (e.g. number of episodes of illness) with lower direct medical costs (88 Euros vs 99 Euros) and significantly less sick-leave (9.5% of parents vs 31.6% of parents).
  • Trichard M, Chaufferin G Nicoloyannis N. Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children. Homeopathy, 2005; 94: 3-9.
    http://www.ncbi.nlm.nih.gov/pubmed?term=15751328

Treatment by a homeopath can reduce the need for conventional drugs

A survey involving 223 patients in an NHS General Practice found that over a 1 year period that treatment by a homeopath was made available, the number of consultations with GPs was reduced by 70% and expenses for medication were reduced by 50%.[6]

  • Limitations of the study: The costs of homeopathic treatment were not calculated, preventing a comparison with the savings made in the area of conventional treatment.

A 500-patient survey at the Royal London Homeopathic Hospital showed that many patients were able to reduce or stop conventional medication following homeopathic treatment.[7] The size of the effect varied between diagnoses, for example 72% of patients with skin complaints reported being able to stop or reduce their conventional medication; for cancer patients there was no reduction.

A study compared treatment by a homeopath with conventional treatment for acute ear infections in children. Out of 103 children in the homeopathy group only 5 needed antibiotics. The children receiving homeopathy had faster pain relief during the initial infection and fewer ear infections over the following year.[8]

  • The results found that median duration of pain during acute otitis media (middle ear infection) was 2 days in the homeopathy group; 3 days in conventional care group. 70.7% of the homeopathy group had no recurrence over the following year, compared with 56.5% of conventional care group. 29.3 % of the homeopathy group had a maximum of three ear infections within one year, compared with The study published in the International Journal of Clinical Pharmacology and Therapeutics concluded that homeopathy should be the first line treatment for acute otitis media in children.

Potential impact of homeopathy on the NHS budget

The total amount spent on homeopathy in the NHS is approximately £4 million per year, representing just 0.0004% of the total NHS budget.[9] The available evidence tells us that we have a situation where a comparatively small amount of money is being used to generate a very high level of patient satisfaction, but what could be achieved if use of homeopathy within the NHS was expanded?

To read more information to to our Homeopathy in Practice page (click here)

Leading economist Christopher Smallwood was commissioned to take an independent look at the contribution which complementary therapies can potentially make to the delivery of healthcare in the UK.[10]

He concluded that if only 4% of GPs were to offer homeopathy as a major frontline approach to treatment, this would result in an annual saving for the NHS of £190 million.

Smallwood’s report included a study by Swayne et al. published in 1992 which examined the prescription costs of 22 doctors in the UK found. The study found that practices which included a GP using homeopathy prescribed 12% fewer items of medication per patient (including both conventional drugs and homeopathic medicines) compared with other local practices. Smallwood calculates that if this figure was extrapolated to a national level the number of items prescribed would be reduced by 41.5 million.

Swayne, J. The cost and effectiveness of homeopathy. Br Homeopath J 1992; 81: 148-150

The need for further research

The evidence suggests that if homeopathic treatment was offered as the first option in certain clinical areas, similar or superior results could be achieved at similar or lower costs. The resulting reduction in use of conventional drugs (such as antibiotics for common recurrent childhood infections) could have a positive impact on the NHS drug bill. With such serious issues at stake funding is needed for further research to confirm these results in larger studies.

References

1. http://www.nhs.uk/NHSEngland/aboutnhs/Pages/About.aspx

2. Rawlins M, Culyer AJ. National Institute for Clinical Excellence and its value judgments. BMJ, 2004; 329:224-7

3. Appleby J, et al. NICE’s cost effectiveness threshold (Editorial). BMJ,2007; 335:358-9

4. Witt C, Keil T, Selim D, et al. Outcome and costs of homeopathic and conventional treatment strategies: a comparative cohort study in patients with chronic disorders. Complement Ther Med, 2005; 13: 79-86

5. Trichard M, Chaufferin G Nicoloyannis N. Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children. Homeopathy, 2005; 94: 3–9

7. Christie EA, Ward AT. Report on NHS practice-based homoeopathy project. Analysis of effectiveness and cost of homoeopathic treatment within a GP practice at St. Margaret’s Surgery, Bradford on Avon, Wilts. The Society of Homeopaths, September 1996

6. Sharples F, van Haselen R, Fisher P. NHS patients’ perspective on complementary medicine. Complementary Therapies in Medicine, 2003; 11: 243–8

7. Smallwood, C. The Role of Complementary and Alternative Medicine in the NHS. FreshMinds, October 2005

8. Friese K-H, et al. Homeopathic treatment of otitis media in children: comparisons with conventional therapy. Int J Clin Pharmacol Ther, 1997; 35: 296-301
9. British Homeopathic Association. An overview of NHS homeopathy Cited 11-09. Available at: http://www.britishhomeopathic.org/what_you_can_do/campaign_for_homeopathy/nhs_homeopathy_overview.html