MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Whenever there are discussions about homeopathy (currently, they have reached fever-pitch both in France and in Germany), one subject is bound to emerge sooner or later: its cost. Some seemingly well-informed person will exclaim that USING MORE HOMEOPATHY WILL SAVE US ALL A LOT OF MONEY.

The statement is as predictable as it is wrong.

Of course, homeopathic remedies tend to cost, on average, less than conventional treatments. But that is beside the point. A car without an engine is also cheaper than one with an engine. Comparing the costs of items that are not comparable is nonsense.

What we need are proper analyses of cost-effectiveness. And these studies clearly fail to prove that homeopathy is a money-saver.

Even researchers who are well-known for their pro-homeopathy stance have published a systematic review of economic evaluations of homeopathy. They included 14 published assessments, and the more rigorous of these investigations did not show that homeopathy is cost-effective. The authors concluded that “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“.

Probably the most meaningful study in this area is an investigation by another pro-homeopathy research team. Here is its abstract:

OBJECTIVES:

This study aimed to provide a long-term cost comparison of patients using additional homeopathic treatment (homeopathy group) with patients using usual care (control group) over an observation period of 33 months.

METHODS:

Health claims data from a large statutory health insurance company were analysed from both the societal perspective (primary outcome) and from the statutory health insurance perspective (secondary outcome). To compare costs between patient groups, homeopathy and control patients were matched in a 1:1 ratio using propensity scores. Predictor variables for the propensity scores included health care costs and both medical and demographic variables. Health care costs were analysed using an analysis of covariance, adjusted for baseline costs, between groups both across diagnoses and for specific diagnoses over a period of 33 months. Specific diagnoses included depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.

RESULTS:

Data from 21,939 patients in the homeopathy group (67.4% females) and 21,861 patients in the control group (67.2% females) were analysed. Health care costs over the 33 months were 12,414 EUR [95% CI 12,022-12,805] in the homeopathy group and 10,428 EUR [95% CI 10,036-10,820] in the control group (p<0.0001). The largest cost differences were attributed to productivity losses (homeopathy: EUR 6,289 [6,118-6,460]; control: EUR 5,498 [5,326-5,670], p<0.0001) and outpatient costs (homeopathy: EUR 1,794 [1,770-1,818]; control: EUR 1,438 [1,414-1,462], p<0.0001). Although the costs of the two groups converged over time, cost differences remained over the full 33 months. For all diagnoses, homeopathy patients generated higher costs than control patients.

CONCLUSION:

The analysis showed that even when following-up over 33 months, there were still cost differences between groups, with higher costs in the homeopathy group.

A recent analysis confirms this situation. It concluded that patients who use homeopathy are more expensive to their health insurances than patients who do not use it. The German ‘Medical Tribune’ thus summarised the evidence correctly when stating that ‘Globuli are m0re expensive than conventional therapies’. This quote mirrors perfectly the situation in Switzerland which as been summarised as follows: ‘Globuli only cause unnecessary healthcare costs‘.

But homeopaths (perhaps understandably) seem reluctant to agree. They tend to come out with ever new arguments to defend the indefensible. They claim, for instance, that prescribing a homeopathic remedy to a patient would avoid giving her a conventional treatment that is not only more expensive but also has side-effects which would cause further expense to the system.

To some, this sounds perhaps reasonable (particularly, I fear, to some politicians), but it should not be reasonable argument for responsible healthcare professionals.

Why?

Because it could apply only to the practice of bad and unethical medicine: if a patient is ill and needs a medical treatment, she does certainly not need something that is ineffective, like homeopathy. If she is not ill and merely wants a placebo, she needs assurance, compassion, empathy, understanding and most certainly not an expensive and potentially harmful conventional therapy.

To employ the above analogy, if someone needs transport, she does not need a car without an engine!

So, whichever way we twist or turn it, the issue turns out to be quite simple:

WHITHOUT EFFECTIVENESS, THERE CAN BE NO COST-EFFECTIVENESS!

29 Responses to Some people claim that we can save money with homeopathy – well, they are wrong!

  • Conventional medicine is the 3rd leading cause of death in the US (300,000 per year, or about two 911-scale disasters per week) and the leading cause of personal bankruptcy. Per capita US spends more than double what every other wealthy country spends, while ranking in the 30’s in health results. Lets set up a homeopathic hospital like there used to be in the US and still are in India, and have it go head to head with a conventional hospital and compare cost-effectiveness. Wouldnt our conventional medical establishment be happy to prove its supposed superiority in such a clear experiment rather than just having “skeptics” spouting off about it?

    • Roger

      If homeopathic hospitals are going to be as effective as you believe, how come the ones in the US aren’t still there?

      If you can provide us with any credible evidence of homeopathy’s effectiveness in treating anything other than Heavy Wallet Syndrome, please provide it.

      Conventional medicine HAS proved its superiority over the imaginary powers of shaken water, Roger. That you fancifully believe otherwise is your problem, not conventional medicine’s.

      You are claiming homeopathy to be effective. It is up to you to prove it.

      • You can easily look up why they arent still here, but had nothing to do with whether they were effective or not. That was never considered in the process.

        • You’re the one making the claims, Roger. You tell us why they aren’t there. Enlighten us.

          • Carnegie commissioned the Flexner report. Flexner a priori decided that “scientific” (i.e. conventional medicine which wasnt very scientific) was the only medicine that made sense, and his report reflected that bias. Carnegie and Rockefeller Institutes put their money and influence behind his conclusions at the state and federal levels. Within a short time across the USA any other type of medical hospital or medical school was converted or shut down. J.D.Rockefeller who personally used homeopathy and lived healthy until 90 y.o. and son of a literal patent snake-oil salesman, knew he could make a lot more money from conventional patented medicine than he could from homeopathy. At no point was any effort made to measure the effectiveness of any form of medicine. Thus the USA has the medical monopoly that we currently “enjoy”. “Monopoly favors the rich (on the whole) just as competition (on the whole) favors the poor.”

  • Homeopathy costs are more expensive up front, because that is when the doctors spend the most time with the patient. You walk into a conventional doctor’s office with arthritis and limp out 15 min later with a prescription for a pain killer. The costs for conventional medicine are backloaded when a few years later the patient’s health collapses under the load of 8-12 drugs. Most of the expense of conventional medicine is in the last few years of life with massively expensive tests, drugs, and procedures to maintain a poor quality of life.

  • Ernie, Ernie, Ernie. You selected ONE study that showed increased costs from homeopathic treatment, but we ALL know that you are simply cherry-picking because there are MANY other studies that show cost savings from homeopathic treatment.

    A comprehensive review of the literature on cost-effectiveness studies was conducted and published in a leading health economics journal (Viksveen, Dymitr, Simoens, 2014).
    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.
    The researchers concluded that the identified evidence of the costs and potential benefits of homeopathy were deemed promising, but the 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.
    In 2015, a comparative economic analysis was published in a leading health economics journal, comparing various costs connected to MDs who practiced and who specialize in homeopathy, MDs who practiced CAM (including some homeopathy), and MDs who practiced conventional medicine (Colas, Danno, Tabar, et al, 2015). This “EPI3 study” was a French pharmaco-epidemiological study with a follow-up of 1-year that included a representative sample of GPs and their patients between March 2007 and July 2008.
    With regard to data drawn from the French government’s Social Security program, treatment by MD/homeopaths was less costly (42.00 € vs 65.25 € for conventional MDs, 35 % less). Medical prescriptions were two-times more expensive for conventional MDs’ patients (48.68 € vs 25.62 €). For the supplementary health insurance and/or patient out-of-pocket costs, treatment by conventional MDs was less expensive due to the lower consultation costs (6.19 € vs 11.20 € for MD/homeopaths) whereas the prescription cost was comparable between the MD/homeopaths’ and the conventional MDs’ patients (15.87 € vs 15.24 € respectively) . The health expenditure cost was 20 % less for patients consulting MD/homeopaths compared to conventional MDs (68.93 € vs 86.63 €, respectively). The lower cost of medical prescriptions for MD homeopaths patients compared to conventional MDs’ patients (41.67 € vs 63.72 €) was offset by the higher consultation costs (27.08 € vs 22.68 € respectively). MD/homeopaths prescribed fewer psychotropic drugs, antibiotics and non-steroidal anti-inflammatory drugs.

    Colas A, Danno K, Tabar C, Ehreth J, Duru G. Economic impact of homeopathic practice in general medicine in France. Health Economics Review20155:18. DOI: 10.1186/s13561-015-0055-5. http://healtheconomicsreview.springeropen.com/articles/10.1186/s13561-015-0055-5

    Viksveen P, Dymitr Z, Simoens S. Economic evaluations of homeopathy: a review. Eur J Health Econ. 2014:15,157-174 . http://www.ncbi.nlm.nih.gov/pubmed/23397477

    • no DUllie, I pointed out the methodologically BEST study and also cited a systematic review.
      btw: you forgot to mention that Viksveen et al concluded this: ‘ It is therefore not possible to draw firm conclusions based on existing economic evaluations of homeopathy.’
      and Colas et al: did you not see this in their paper?: ‘Financial support
      Laboratoires Boiron provided financial support for the analysis.
      Competing interests
      AC, KD and CT are employees of Laboratoires Boiron’
      ONE COULD ALMOST GET THE INPRESSION THAT YOU ARE SLIGHTLY BIASED, DULLIE!

      • I think that it is great when researchers are humble…and when they acknowledge that no “firm conclusions” can be made. I am more suspicious of researchers who conduct one study and who assert that “firm conclusions” can be made.

        Humility is good…and in fact, the best scientists are humble.

  • USING MORE HOMEOPATHY WILL SAVE US ALL A LOT OF MONEY

    At first sight, I would think this to be correct: far more patients will die far sooner and therefore need less treatment, which leads to dramatic savings. It also leads to far more far shorter lives, but I am guessing that homeopaths don’t care about that, as long as they get enough well-heeled victims to pay for their lives of leisure.

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