Alternative therapies could save the NHS money, says report commissioned by Prince Charles
BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7520.795-a (Published 06 October 2005) Cite this as: BMJ 2005;331:795Data supplement
Alternative therapies could save the NHS money, says report commissionied by Prince Charles
Roger Dobson
Many complementary treatments could make an important contribution to health care in the United Kingdom, says a report commissioned by the Prince of Wales and published this week.
Greater use of some complementary treatments could result in major savings in healthcare costs too, says the report, which also calls for the National Institute for Health and Clinical Excellence to carry out a full assessment of the cost effectiveness of such treatments.
"Despite the fragmentary nature of the evidence, there seems good reason to believe that a number of complementary and alternative medicine treatments offer the possibility of significant savings in direct health costs," says the report.
The report, which concentrates on the "big five" complementary treatments—acupuncture, homoeopathy, chiropractic, osteopathy, and herbal medicine—also says that deprived communities in particular could benefit from the treatments.
On homeopathy, it says, "There is a large literature on the costs and benefits of homeopathy, and many studies over the past 40 years—randomised controlled trials in humans and animals as well as cost-effectiveness studies—appear to suggest that homeopathy is better than placebo in placebo-controlled trials, although these results are hotly contested."
On herbal medicine the report says: "The literature scan for this section of the enquiry suggests that there is evidence of clinical benefit relating to musculoskeletal problems, including rheumatoid arthritis, viral infections and the common cold, osteoarthritis, depression, Alzheimer’s disease and dementia, heart problems, circulatory problems and benignly enlarged prostate."
Christopher Smallwood, the economist who chaired the investigation for the report, said, "We are not talking about sweeping savings. What we are saying is that as far as individual therapies are concerned, some of them are likely to be cheaper than conventional medicine, but that cost savings will only arise in relation to particular treatments. There are of course benefits to the wider economy, because complementary therapies can get people back to work quickly.
"We were impressed by the amount of evidence that has accumulated which suggests that complementary and alternative therapies have the potential to make an important contribution to the delivery of health care. The main areas identified relate to chronic and complex conditions, anxiety stress and depression, and palliative care relating particularly to pain and nausea."
In response to criticism that the inquiry was led by an economist, he said, "It is an independent inquiry and they wanted someone who wasn’t partisan. It was thought appropriate to have an economist because it essentially involved looking at costs and benefits."
Edzard Ernst, professor of complementary and alternative medicine at the University of Exeter, who criticised the report’s conclusions when a draft was leaked earlier this year, said, "There have not been enough rigorous studies on the cost effectiveness of complementary treatments, and those which have taken place have found they would add to the cost of the NHS.
"The chairman is an economist, and in conversations he told me he knew nothing at all about health care and even less of complementary medicine, and he believed this to be good because he would not be biased. But bias can be eliminated by proper methodology, and it is expertise that you need. I cannot be a butcher or car mechanic tomorrow because I am a scientist. He is an economist and not a scientist."
The Role of Complementary and Alternative Medicine in the NHS can be found at www.freshminds.co.uk
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