A number of German health insurances are offering integrated care contracts for homeopathy (ICCHs) that cover the reimbursement of homeopathy. But the effectiveness and cost-effectiveness of these contracts are highly questionable. Now a team of German researchers evaluated the effectiveness and cost-effectiveness of treatment after an additional enrolment in an ICCH in a comparative, prospective, observational study (sponsored by the health insurance company Techniker Krankenkasse).
The participants in the ICCH (HOM group) were compared with matched (on diagnosis, sex and age) insured individuals (CON group) who received usual care alone. Those insured with either
- migraine or headache,
- allergic rhinitis,
- atopic dermatitis,
were included. Primary effectiveness outcomes were the baseline adjusted scores of diagnosis-specific questionnaires (e.g. RQLQ, AQLQ, DLQI, BDI-II) after 6 months. Primary cost-effectiveness endpoints were the baseline adjusted total costs from an insurer perspective in relation to the achieved quality-adjusted life years (QALYs). Costs were derived from health claims data and QALYs were calculated based on SF-12 data.
Data from 2524 participants (1543 HOM group) were analysed. The primary effectiveness outcomes after 6 months were statistically significant in favour of the HOM group for:
- migraine or headache (Δ = difference between groups, days with headache: – 0.9, p = 0.042),
- asthma (Δ-AQLQ(S): + 0.4, p = 0.014),
- atopic dermatitis (Δ-DLQI: – 5.6, p ≤ 0.001),
- depression (Δ-BDI-II: – 5.6, p ≤ 0.001).
Only the BDI-II differences reached the minimal clinically important difference.
For all diagnoses, the adjusted mean total costs over 12 months were higher in the HOM group from an insurer perspective, with
- migraine or headache,
- atopic dermatitis,
suggesting cost-effectiveness in terms of additional costs per QALY gained.
The authors concluded that after an additional enrolment in the ICCH, the treatment of participants with depression showed minimally clinically relevant improvements. From an insurer perspective, treatment with an ICCH enrolment resulted in higher costs over all diagnoses but seemed to be cost-effective for migraine or headache, atopic dermatitis and depression according to international used threshold values. Based on the study design and further limitations, our findings should be considered cautiously and no conclusions regarding the effectiveness of specific treatment components can be made. Further research is needed to overcome limitations of this study and to confirm our findings.
Normally, I find newly published studies by conducting Medline searches. This one, I found because the insurance company in question, the Techniker Krankenkasse, is already using it for their advertising. No wonder – this is not a scientific study but a clever marketing coup!
THE RESULTS OF THIS ‘STUDY’ WERE CLEAR, EVEN BEFORE THE FIRST PATIENT WAS RECRUITED.
Imagine you are a patient with one of the 5 conditions listed above, and you evidently like homeopathy – so much so that you approach your insurance and ask to get cover for homeopathy at extra cost to yourself. These were the patients of experimental group. They were compared to patients who could not care less about homeopathy and thus did not get this extra cover.
Who do you think claims to feel better in a self-administered questionnaire?
Is there anyone surprised at the findings of this study?
Well, actually I am a little surprised. Not that the results were positive, but that the results were not more positive. With such a monsterous bias built in the ‘study’, I would have expected much larger differences.
And I am surprised about something else too: how come BMC Health Services Research publishes such promotional marketing masquerading as scientific research?
This clever marketing coup can in no way determine the effectiveness of homeopathy. For that, we need RCTs of which there are already plenty; and we all know what they show: the effects of homeopathy are indistinguishable from those of placebo.
This means there is no proven effectiveness. And what did the director of NICE England once tell me?
WHERE THERE IS NO EFFECTIVENESS, THERE CAN ALSO BE NO COST-EFFECTIVENESS!
Dug this out of the way-back machine: https://www.karger.com/Article/FullText/355916
Quote: “However, meta-analyses can arrive at different conclusions despite being based on virtually the same material. They are not performed according to strict methodology and are, to a variable extent, guided by creativity, interpretation, and personal bias. This is why everyone can find arguments for and against homeopathy in the meta-analyses of the pooled clinical data.” So much for RCTs proving anything. Let everyone prove it to their own satisfaction, and find some other line of work, Edzard.
you are not quite tuned in, Roger.
meta-analyses and RCTs are 2 different methodologies; and there are meta-analyses without RCTs.
you really need to inform yourself a little before you start typing utter trash.
I know quite well the difference between meta-analyses and RCTs. Both are flawed and subject to bias. Read Harris Coulter’s book, Controlled Clinical Trial.
Standard homeopaths’ whine. Whatever demonstrates their fanciful notions to be false has to be wrong whether it be mathematics, statistics, biology, physics or chemistry. They all have to be wrong. Because homeopaths know they are right.
Meanwhile the World turns and homeopathy remains the fanciful nonsense it always has been.
Nothing in homeopathy invalidates what is KNOWN about mathematics, statistics, biology, physics or chemistry. So-called skeptics keep whining that it does. You just dont know everything there is to know in the universe, as much as you would like to think so.
Where is the original document of this new study? (15,700 SECURVITA policyholders)
Who has peer reviewed the publication?
Quote from this article from September 15, 2020 (but there is no link to the original document)
“The study was carried out for SECURVITA Krankenkasse by the Health Forum Leipzig, an analysis institute specializing in health services research. The basis for the data collection is a contract between SECURVITA Krankenkasse and the National Association of Statutory Health Insurance Physicians (KBV). Statutory health insurance physicians with additional homeopathic qualifications have been treating the insured with SECURVITA since 2009 on the basis of this contract and offer them intensive anamnesis discussions, homeopathic advice and therapeutic support.”
nobody can judge this without an original document of the study.
Take your pick everybody:Results of a meta analysis re effectiveness of homeopathy:
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.
Eur J Health Econ . 2014 Mar;15(2):157-74.
doi: 10.1007/s10198-013-0462-7. Epub 2013 Feb 10.
Economic evaluations of homeopathy: a review
Petter Viksveen 1 , Zofia Dymitr, Steven Simoens
• DOI: 10.1007/s10198-013-0462-7
Context: Economic evaluations of commonly used complementary and alternative medicine (CAM) therapies such as homeopathy are needed to contribute to the evidence base on which policy makers, clinicians, health-care payers, as well as patients base their health-care decisions in an era of constrained resources.
Objectives: To review and assess existing economic evaluations of homeopathy.
Methods: Literature search was made to retrieve relevant publications using AMED, the Cochrane Library, CRD (DARE, NHS EED, HTA), EMBASE, MEDLINE, and the journal Homeopathy (former British Homoeopathic Journal). A hand search of relevant publications was carried out. Homeopathy researchers were contacted. Identified publications were independently assessed by two authors.
Results: 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. Studies were highly heterogeneous and had several methodological weaknesses.
Conclusions: 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. Recommendations for future research are presented.
did you read even as much as the conclusion of this paper?
did you notice that it is 8 years old?