Complementary medicine could ease health budget

2010 Sep 13 - Economic report finds complementary medicine could ease health budget 
A study into the cost effectiveness of complementary medicine in Australia has found the nation could potentially save millions in healthcare costs without compromising patient outcomes if complementary medicine is more widely used.
The research conducted by Access Economics for the National Institute of Complementary Medicine (NICM) at the University of Western Sydney examined the cost effectiveness of selected complementary medicine (CM) treatments for some of Australia's most common and costly chronic health problems including: low back pain, heart disease, depression and arthritis.
Access Economics analysed interventions such as St John's wort, fish oils, acupuncture and an herbal anti-inflammatory preparation.
Professor Alan Bensoussan, Executive Director of NICM, says the growing scientific evidence for complementary medicine as an effective adjunct or replacement for some standard treatments demands the economic benefits of complementary medicine also be systematically studied.
"The clinical evidence showing some complementary medicine can play a vital role in improving an individual's health has been clear for some time, now this report shows complementary medicine could also improve the health of the healthcare system," says Professor Bensoussan, who is also Director of the Centre for Complementary Medicine Research at UWS.
Lynne Pezzullo, Director of Access Economics, says the ‘Cost effectiveness of complementary medicines' report identified substantial dollar savings even though only the direct healthcare costs were examined and indirect costs, such as productivity losses, were excluded.
"The economic benefits of complementary medicine would be much larger than we report if the significant flow-on benefits of keeping people healthy, able to work and out of an already over stretched hospital system were included," says Ms Pezzullo.
The report authors acknowledged the added expense of the Goods and Services Tax on complementary medicines may impede more wide use of some treatments and recommended governments review their strategy as evidence for the clinical and cost effectiveness of the CM grows.
The study found taking fish oil supplements was a highly cost effective intervention to prevent heart disease for those who had already had a myocardial infarction (heart attack). Previous clinical studies show fish oil supplements are an effective treatment for those recovering from a heart attack.
The report found using St John's wort - which clinical trials have shown is as effective as standard drug treatments for mild-moderate depression - in place of pharmaceutical antidepressants, could save nearly $50 million each year.  While the recommended first-line treatments for depression remain non-pharmacological, for example cognitive behaviour therapy, and patients on St John's wort would most likely still be monitored and treated by medical practitioners, the savings from using the herbal treatment would flow from the lower per dose cost.  However, before St John's wort becomes more widely used, additional work will need to be done to standardise the preparation and closely examine interactions with other drug treatments.
The authors' analysis of previous clinical trials found acupuncture for chronic non-specific low back pain (LBP) as a complement to standard care resulted in significantly better pain outcomes compared to standard care alone. The report concluded acupuncture as a complement to standard care for chronic LBP is very cost effective. Additionally, if associated absenteeism and reduced work effectiveness are averted and other indirect financial costs such informal carers are considered, Access Economics estimate the benefits from acupuncture would more than double.
An analysis of the herbal preparation, Phytodolor, as a treatment for osteoarthritis has found it could potentially reduce the cost of treatment.  Several clinical trials have shown Phytodolor can help some patients manage pain and control inflammation. 
The report authors calculated if all Australians with osteoarthritis take non-steroidal anti inflammatory drugs (NSAIDs) and switch to Phytodolor there would be a potential cost saving of up to $178 million each year.
Currently, Australian healthcare costs exceed $100 billion every year and it has been rising year on year for decades. [1]
In 1960-61 health expenditure was 3.8 percent of GDP but had grown by 2007-08 to 9.1 percent of GDP [1].
Australia spends almost five times on healthcare per person compared to fifty years ago [2] and our life expectancy and quality of life have vastly improved. However, Professor Bensoussan says it may be difficult to continue to reap the benefits of scientific advances without widely adopting cheaper, but just as effective, treatment options.
"Complementary medicines could defray the high costs of modern health care by offering better disease prevention and more effective management of chronic conditions," he says.
"The current focus on ‘restructuring' the Australian health system to save money would benefit from broadening the review to include better integration of cost effective complementary medicine into daily medical practice. The health of the nation and the national budget may ultimately rest on a full scientific and economic analysis of complementary medicine."
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Paul Grocott, Senior Media Officer
University of Western Sydney
02 9678 7083, 0406 429 304
[1] Australian Institute of Health and Welfare 2009. Health expenditure Australia 2007-08.
Health and welfare expenditure series no. 37. Cat. no. HWE 46. Canberra: AIHW.

[2] Australian Institute of Health and Welfare Expenditure Summary
Last Updated ( Sunday, 12 September 2010 )