The European Journal of Health Economics

, Volume 15, Issue 2, pp 157–174 | Cite as

Economic evaluations of homeopathy: a review

Original Paper

Abstract

Context

Economic evaluations of commonly used complementary and alternative medicine (CAM) therapies such as homeopathy are needed to contribute to the evidence base on which policy makers, clinicians, health-care payers, as well as patients base their health-care decisions in an era of constrained resources.

Objectives

To review and assess existing economic evaluations of homeopathy.

Methods

Literature search was made to retrieve relevant publications using AMED, the Cochrane Library, CRD (DARE, NHS EED, HTA), EMBASE, MEDLINE, and the journal Homeopathy (former British Homoeopathic Journal). A hand search of relevant publications was carried out. Homeopathy researchers were contacted. Identified publications were independently assessed by two authors.

Results

Fifteen relevant articles reported on 14 economic evaluations of homeopathy. Thirteen studies reported numbers of patients: a total of 3,500 patients received homeopathic treatment (median 97, interquartile range 48–268), and 10 studies reported on control group participants (median 57, IQR 40–362). Eight out of 14 studies found improvements in patients’ health together with cost savings. Four studies found that improvements in homeopathy patients were at least as good as in control group patients, at comparable costs. Two studies found improvements similar to conventional treatment, but at higher costs. Studies were highly heterogeneous and had several methodological weaknesses.

Conclusions

Although the identified evidence of the costs and potential benefits of homeopathy seemed promising, studies were highly heterogeneous and had several methodological weaknesses. It is therefore not possible to draw firm conclusions based on existing economic evaluations of homeopathy. Recommendations for future research are presented.

Keywords

Complementary and alternative medicine Economic evaluations Homeopathy Cost-effectiveness 

JEL Classification

C18 – Methodological Issues: General I10 – General I11 – Analysis of Health Care Markets I12 – Health Production I13 – Health Insurance, Public and Private I15 – Health and Economic Development 

References

  1. 1.
    Frass, M., Strassl, R.P., Friehs, H., Müllner, M., Kundi, M., Kaye, A.D.: Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J 12(1), 45–56 (2012)PubMedCentralPubMedGoogle Scholar
  2. 2.
    World Health Organization (WHO): WHO Traditional Medicine Strategy 2002–2005. Geneva: WHO/EDM/TRM 2002.1Google Scholar
  3. 3.
    Fisher, P.: What is homeopathy? An introduction. Front Biosci E4, 1669–1682 (2012)CrossRefGoogle Scholar
  4. 4.
    Linde, K., Mondras, M., Vickers, A., ter Riet, G., Melchart, D.: Systematic reviews of complementary therapies: an annotated bibliography. Part 3: Homeopathy. BMC Complement Altern Med 1:4. http://www.biomedcentral.com/1472-6882/1/4 (2001). Accessed 18 April 2012
  5. 5.
    Ernst, E.: A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol 54, 577–582 (2002)PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Bornhöft, G., Wolf, U., von Ammon, K., Righetti, M., Maxion-Bergemann, S., Baumgartner, S., Thurneysen, A., Matthiessen, P.F.: Effectiveness, safety and cost-effectiveness of homeopathy in general practice: summarized health technology assessment. Forsch Komplementärmed 13(suppl 2), 19–29 (2006)CrossRefGoogle Scholar
  7. 7.
    Kelner, M.J., Boon, H., Wellman, B., Welsh, S.: Complementary and alternative groups contemplate the need for effectiveness, safety and cost-effectiveness research. Compl Ther Med 10, 235–239 (2002)CrossRefGoogle Scholar
  8. 8.
    Smallwood, C.: The role of complementary and alternative medicine in the NHS. An investigation into the potential contribution of mainstream complementary therapies to healthcare in the UK. http://www.getwelluk.com/uploadedFiles/Publications/SmallwoodReport.pdf (2005). Accessed 7 April 2012
  9. 9.
    Drummond, M.F., Sculpher, M.J., Torrance, G.W., O’Brien, B.J., Stoddart, G.L.: Methods for the economic evaluation of health care programmes, 3rd edn. Oxford University Press, Oxford (2005)Google Scholar
  10. 10.
    Higgins, J. P. T., Altman, D. G., Sterne, J. A. C.: Chapter 8: Assessing risk of bias in included studies. In: Higgins, J. P. T., Green, S. (eds.) Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. http://www.cochrane-handbook.org Accessed 18 April 2012
  11. 11.
    Cochrane Consumers and Communication Review Group (Cochrane CCRG). Data extraction template for Cochrane reviews. Version 1.5.0, updated 3 May 2001. http://www.latrobe.edu.au/chcp/cochrane/resources.html Accessed 18 April 2012
  12. 12.
    Bachinger, A., Rappenhöner, B., Rychlik, R.: Socioeconomic effectiveness of Zeel comp.-therapy compared to patients with hyaluronic acid in patients suffering from osteoarthritis of the knee. [Zur sozioökonomischen Effizienz einer Zeel comp.-Therapie im Vergleich zu Hylauronsäure bei Patienten mit Gonarthrose.] [German] Z Orthop 134(4) (1996)Google Scholar
  13. 13.
    Feldhaus, H.W.: Cost-effectiveness of homoeopathic treatment in a dental practice. Br Homeopath J 82, 22–28 (1993)CrossRefGoogle Scholar
  14. 14.
    Frei, H., Thurneysen, A.: Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? Br Homeopath J 90, 180–182 (2001)PubMedCrossRefGoogle Scholar
  15. 15.
    Kneis, K.C., Gandjour, A.: Economic evaluation of Sinfrontal in the treatment of acute maxillary sinusitis in adults. Appl Health Econ Health Policy 7(3), 181–191 (2009)PubMedCrossRefGoogle Scholar
  16. 16.
    Kooreman, P., Baars, E.: Patients whose GP knows complementary medicine tend to have lower costs and live longer. Eur J Health Econ (2010). doi:10.1007/s10198-011-0330-2 Google Scholar
  17. 17.
    Paterson, C., Ewings, P., Brazier, J.E., Britten, N.: Treating dyspepsia with acupuncture and homeopathy: reflections on a pilot study by researchers, practitioners and participants. Compl Ther Med 11, 78–84 (2003)CrossRefGoogle Scholar
  18. 18.
    Pomposelli, R., Piasere, V., Andreoni, C., Costini, G., Tonini, E., Spalluzzi, A., Rossi, D., Quarenghi, C., Zanolin, M.E., Bellavite, P.: Observational study of homeopathic and conventional therapies in patients with diabetic polyneuropathy. Homeopathy 98, 17–25 (2009)PubMedCrossRefGoogle Scholar
  19. 19.
    Sevar, R.: Audit of outcome in 455 consecutive patients treated with homeopathic medicines. Homeopathy 94, 215–221 (2005)PubMedCrossRefGoogle Scholar
  20. 20.
    Slade, K., Chohanand, B.P.S., Barker, P.J.: Evaluation of a GP practice based homeopathy service. Homeopathy 93, 67–70 (2004)PubMedCrossRefGoogle Scholar
  21. 21.
    Thompson, E.A., Shaw, A., Nichol, J., Hollinghurst, S., Henderson, A.J., Thompson, T., Sharp, D.: The feasibility of a pragmatic randomised controlled trial to compare usual care with usual care plus individualised homeopathy, in children requiring secondary care for asthma. Homeopathy 100(3), 122–130 (2011)PubMedCrossRefGoogle Scholar
  22. 22.
    Trichard, M., Chaufferin, G., Dubreuil, C., Nicoloyannis, N., Duru, G.: Effectiveness, quality of life, and cost of caring for children in France with recurrent acute rhinopharyngitis managed by homeopathic or non-homeopathic general practitioners. Dis Manage Health Outcomes 12(6), 419–427 (2004)CrossRefGoogle Scholar
  23. 23.
    Trichard, M., Chaufferin, G., Nicoloyannis, N.: Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children. Homeopathy 94, 3–9 (2005)PubMedCrossRefGoogle Scholar
  24. 24.
    Van Wassenhoven, M., Ives, G.: An observational study of patients receiving homeopathic treatment. Homeopathy 93, 3–11 (2004)PubMedCrossRefGoogle Scholar
  25. 25.
    Witt, C., Keil, T., Selim, D., Roll, S., Vance, W., Wegscheider, K., Willich, S.N.: Outcome and costs of homoeopathic and conventional treatment strategies: a comparative cohort study in patients with chronic disorders. Compl Ther Med 13, 79–86 (2005)CrossRefGoogle Scholar
  26. 26.
    Witt, C.M., Brinkhaus, B., Pach, D., Reinhold, T., Wruck, K., Roll, S., Jäckel, T., Staab, D., Wegscheider, K., Willich, S.N.: Homoeopathic versus conventional therapy for atopic eczema in children: medical and economic results. Dermatology 291, 329–340 (2009)CrossRefGoogle Scholar
  27. 27.
    Paterson, C., Britten, N.: In pursuit of patient-centred outcomes: a qualitative evaluation of MYMOP2, measure yourself medical outcome profile. J Health Serv Res Policy 5, 27–36 (2000)PubMedGoogle Scholar
  28. 28.
    Herman, P.M., MCraig, B., Caspi, O.: Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med 5, 11 (2005). doi:10.1186/1472-6882-5-11 PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Hulme, C., Long, A.F.: Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine. J Altern Complement Med 11(1), 179–188 (2005)PubMedGoogle Scholar
  30. 30.
    Robinson, N., Donaldson, J., Watt, H.: Auditing outcomes and costs of integrated complementary medicine provision. The importance of length of follow up. Compl Ther Clin Pract 12, 249–257 (2006)CrossRefGoogle Scholar
  31. 31.
    Weatherley-Jones, E., Thompson, E.A., Thomas, K.J.: The placebo-controlled trial as a test of complementary and alternative medicine: observations from research experience of individualised homeopathic treatment. Homeopathy 92, 186–189 (2004)CrossRefGoogle Scholar
  32. 32.
    Walach, H.: Entangled–and tied in knots! Practical consequences of an entanglement model for homeopathic research and practice. Homeopathy 94, 96–99 (2005)PubMedCrossRefGoogle Scholar
  33. 33.
    Walach, H.: Generalized entanglement: a new theoretical model for understanding the effects of complementary and alternative medicine. J Altern Complement Med 11(3), 549–559 (2005)PubMedGoogle Scholar
  34. 34.
    Relton, C., Torgerson, D., O’Cathain, A., Nicholl, J.: Rethinking pragmatic randomised controlled trials: introducing the “cohort multiple randomised controlled trial” design. BMJ 340, c1066 (2010). doi:10.1136/bmj.c1066 PubMedCrossRefGoogle Scholar
  35. 35.
    Malekzadeh, R.: POLYIRAN in primary and secondary prevention of cardiovascular disease in middle-aged and elderly Iranians. ClinicalTrials.gov Identifier: NCT01271985. http://clinicaltrials.gov/ct2/show/study/NCT01271985 (2012) Accessed 4 May 2012
  36. 36.
    National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care, South Yorkshire (NIHR CLAHRC SY).: Participants–Research projects. http://clahrc-sy.nihr.ac.uk/index.html (2012) Accessed 4 May 2012
  37. 37.
    Relton, C., Bissell, P., Smith, C., Blackburn, J., Cooper, C.L., Nicholl, J., Tod, A., Copeland, R., Loban, A., Chater, T., Thomas, K., Young, T., Weir, C., Harrison, G., Millbourn, A., Manners, R.: South Yorkshire Cohort: a ‘cohort trials facility’ study of health and weight: Protocol for the recruitment phase. BMC Public Health; 11:640. http://www.biomedcentral.com/1471-2458/11/640 (2011) Accessed 4 May 2012
  38. 38.
    Hollinghurst, S., Shaw, A., Thompson, E.A.: Capturing the value of complementary and alternative medicine: including patient preferences in economic evaluation. Complement Ther Med (2007). doi:10.1016/j.ctim.2007.10.001 PubMedGoogle Scholar
  39. 39.
    Brooks, R.: EuroQol: the current state of play. Health Policy 37(1), 53–72 (1996)PubMedCrossRefGoogle Scholar
  40. 40.
    EuroQol Group: EuroQol: a new facility for the measurement of health related quality of life. Health Policy 16, 199–208 (1990)CrossRefGoogle Scholar
  41. 41.
    Brazier, J., Usherwood, T., Harper, R., Thomas, K.: Deriving a preference-based single index from the UK SF-36 Health Survey. J Clin Epidemiol 51, 115–128 (1998)CrossRefGoogle Scholar
  42. 42.
    Bridges, J.F.P., Hauber, A.B., Marshall, D., Lloyd, A., Prosser, L.A., Regier, D.A., Johnson, F.R., Mauskopf, J.: Conjoint analysis applications in health—a checklist: a report of the ISPOR good research practices for conjoint analysis task force. Value Health 14, 403–413 (2011)PubMedCrossRefGoogle Scholar
  43. 43.
    Buxton, M.: Assessing the cost-effectiveness of homeopathic medicines: are the problems different from other health technologies? Br Homeopath J 89(Suppl 1), 20–22 (2000)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Petter Viksveen
    • 1
    • 4
  • Zofia Dymitr
    • 2
  • Steven Simoens
    • 3
  1. 1.School of Health and Related ResearchUniversity of SheffieldSheffieldUK
  2. 2.DorchesterUK
  3. 3.Research Centre for Pharmaceutical Care and Pharmaco-economicsKU LeuvenLeuvenBelgium
  4. 4.SandnesNorway

Personalised recommendations