A Systematic Overview of Economic Assessments of CAM Published in 2001–2010 (USA)

The demand for CAM in the USA is ever-growing and according to surveys, at least one in three American adults regularly makes use of it. In 2007, CAM therapy expenses accounted for 11% of all health care expenses in the USA. In relation to this trend, the economic assessment of cost effectiveness of CAM therapies has been carried out over time.
Public health and healthcare economics experts from several US universities (including the University of Arizona; the University of Maryland School of Medicine; Harvard Medical School; and Harvard School of Public Health) have compiled a complete systematic overview of published economic assessments of CAM based on bibliographic databases. The aim was to identify and revise the published economic assessments of CAM, and to formulate recommendations for public health care strategies. In comparison to similar studies, this study involved a significantly higher number of economic assessments (338 in overall) published in 1979–2011.
The results were published in 2012 in the article Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations (36).
In regards to the potential economic contribution of CAM, the results are favourable and it is recommended that further research is carried out. The abstract of the article is cited below:



A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts.

Data sources:
PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted.

Eligibility criteria for selecting studies:
Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included.

Study appraisal methods:
All recent (and likely most cost-relevant) full economic evaluations published 2001-2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported.

A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460).

This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies.”