Homeopathy and cost-effectiveness
A full-scale economic evaluation of homeopathy has not taken place, largely because of the expensive and complex nature of the research required. Some observational and quasi-experimental studies have recorded the outcomes and costs of treatment by General Practitioners (GPs) who integrated homeopathy in their practice, compared with those who did not:
In a German study, for instance, Witt et al. (2005) compared homeopathic and conventional GPs’ outcomes in chronic diagnoses commonly treated in general practice (adults – headache, low back pain, depression, insomnia, sinusitis; children – atopic asthma, dermatitis, rhinitis). They collected data on symptom severity as rated by patient and doctor, quality of life and costs of consultations, medication, physiotherapy, hospitalisation, sick pay and medical devices at 6 and 12 months. The study was sponsored by a health insurance company, which also provided the economic data. 493 patients were treated by 101 homeopathic and 59 conventional GPs. The patients treated by the two groups of GPs were generally similar, although those who attended homeopathic GPs generally had a higher level of education; adjustment was made for these differences in the analysis. The conclusion was that patients who sought homeopathic treatment had better outcomes for similar cost.
In France, Trichard et al. (2005) compared two treatment approaches (‘homeopathic strategy’ versus ‘antibiotic strategy’) used in routine medical practice by allopathic and homeopathic GPs in the management of recurrent acute rhinopharyngitis in 499 18-month to 4-year-old children. The GPs using homeopathy had significantly better results in terms of clinical effectiveness, complications, parents' quality of life and time lost from work, for lower cost to social security. Again there were differences between the groups: the parents of children treated with homeopathy were less likely to smoke (which decreases the risk of recurrent rhinopharyngitis in their children), but their children were more likely to attend day care (which increases the risk); correction was not made for these differences.
These two studies as well as a few other studies of less rigorous design demonstrate that, when comparing the outcomes and costs of treatment by GPs who integrated homeopathy in their practice with those who did not, GPs who integrated homeopathy in their practice achieved better results for similar cost. Homeopathic medicines are much less expensive than conventional prescription drugs, because they are generic, non-patented and non-patentable medicinal substances, produced at low cost. On the other hand, because homeopathic doctors need to obtain a large amount of information from their patients, a longer consultation time is required, leading to more expensive consultations than usual GP consultations. The overall costs of a homeopathic treatment may therefore be comparable to that of conventional treatment.
From a long-term perspective, however, homeopathy is likely to save money, because under proper homeopathic treatment, not only do the patient’s immediate complaints improve, but his/her susceptibility to disease decreases as there is a general improvement in health and thus less need for medical consultations. Several observational studies suggest that patients who are treated with homeopathy use fewer medications, have better health, fewer days off sick, fewer visits to medical specialists and less time in hospital than patients of conventional physicians. Moreover, there are no costs associated with complications due to adverse medication effects.
In conclusion, although patients who seek homeopathic treatment have better outcomes for similar cost, in the long run homeopathy may offer significant cost savings to public health bodies, and to the wider economy, if the wider picture is taken into account. In order to firmly demonstrate the long-term cost savings, more economic studies are warranted.
Dr. Ton Nicolai
President of European Committee for Homeopathy
