Cost-effectiveness Of acupuncture

| February 8, 2010 | 0 Comments | 207 views
Cost-effectiveness will be an important issue for the potential future integration of acupuncture into the NHS. Very little is known about this issue (van Haselen, 1999), and there are few robust studies which have tackled it. Due to the lack of high technology in most CAM therapies, it is a common assumption that they will be less expensive than orthodox medicine. However, CAM consultations may take on average six times longer than GP consultations (Fulder and Munro, 1985). White et al. (1996) outlined four areas where cost savings might be made by using CAM: cost of drugs, visits to GP, secondary referrals and reducing adverse events of orthodox therapy. The analysis used to evaluate these savings can use the same factors that are used within orthodox medicine for economic evaluation; cost-comparison, cost-utility analysis, cost-effectiveness analysis, cost descriptions, and cost benefit analysis (White and Ernst, 2000). However, research conducted into the cost-effectiveness of CAM has tended not to follow such strong theoretical bases.
A systematic review of studies addressing the issue of economic analysis in CAM concluded that there is a lack of experimentally robust studies from which to draw conclusive evidence of differences between the costs and outcomes between complementary therapies and orthodox medicine (White and Ernst, 2000). The majority of studies which report evidence in favour of  the CAM therapies, that is, evidence of reduced referral and treatment costs, are retrospective, while more rigorous and prospective studies suggest CAM is "an additional expense and does not substitute for orthodox care".
Economic analysis of acupuncture has suggested savings in reduced drug expenditure (Myers, 1991), reduced length of stay in hospital (Johansson, 1993) and reduced need for surgery for osteoarthritis of the knee (Christenssen et al., 1992). Lindall (1999) concluded from a study of 65 patients suffering pain , that for selected patients, and when used by an appropriately qualified practitioner, acupuncture appeared to be a cost effective therapy for use in general practice, reducing the need for more expensive hospital referrals. An average minimum total saving for each patient was estimated at £ 232. However, due to methodological limitations the findings of these studies are not conclusive (White and Ernst, 2000). There is a need for high quality research into both the costs and benefits of acupuncture, particularly as primary care groups and trusts outline their health improvement plans in line with a remit to provide a cost-effective service.

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