Kosteneffectiviteit nader bekeken
In het kader van een grote studie in Zwitserland, het zogenaamde 'Schweizerischen Programms zur Evaluation der Komplementärmedizin (PEK)' werden de kosten van alternatieve behandelvormen ook geanalyseerd op basis van een uitgebreid literatuuronderzoek. We vatten de resultaten voor u samen.Met de nodige slagen om de arm concludeerden de onderzoekers, dat de kosten van alternatieve/complementaire behandelvormen lager waren dan die van conventioneel behandelde patienten. De methodologie van kosteneffectiviteitsstudies is altijd enigermate kritiekgevoelig. Dat geldt evenzeer voor studies naar de kosten van effectiviteit van reguliere middelen. Het belangrijkste is dat uit deze studie in ieder geval duidelijk wordt, dat kostenbesparingen mogelijk zijn met complementaire behandelwijzen.[1]
Dat sluit ook aan bij de algemene inzichten. Ook in Nederland vonden we dat anthroposofisch werkzame huisartsen goedkoper werkten dan hun reguliere collega’s.
De samenvatting van het artikel plaatsen we onverkort:
Summary Objective:
The aim of this literature review, performed within the framework of the Swiss governmental Program of Evalua- tion of Complementary Medicine (PEK), was to investigate costs of complementary and alternative medicine (CAM). Materials and Methods: A systematic literature search was conducted in 11 electronic databases. All retrieved titles and reference lists were also hand-searched.
Results:
38 publications were found: 23 on CAM of various definitions (medical and non-medical practitioners, over-the-counter products), 13 on homeopathy, 2 on phytotherapy. Studies investigated different kinds of costs (direct or indirect) and used different methods (prospective or retrospective questionnaires, data analyses, cost-effectiveness models). Most studies report ‘out of pocket’ costs, because CAM is usually not covered by health insurance.
Costs per CAM-treatment / patient / month were AUD7–66, CAD250 and GBP13.62 ±1.61. Costs per treatment were EUR205 (range: 15–1,278), USD414 ±269 and USD1,127. In two analyses phytotherapy proved to be cost-effective. One study revealed a reduction of 1.5 days of absenteeism from work in the CAM group compared to conventionally treated patients. Another study, performed by a health insurance company reported a slight increase in direct costs for CAM. Costs for CAM covered by insurance companies amounted to approximately 0.2–0.5% of the total healthcare budget (Switzerland, 2003).
Publications had several limitations, e.g. efficacy of therapies was rarely reported. As compared to conventional patients, CAM patients tend to cause lower costs.
Conclusion:
Results suggest lower costs for CAM than for conventional patients, but the limited methodological quality lowers the significance of the available data. Further well-designed studies and models are required.
[1] Maxion-Bergemann S, Wolf M, Bornhöft G, Matthiessen PF, Wolf U. | Complementary and alternative medicine costs - a systematic literature review. | Forsch Komplementmed. | 2006;13 Suppl 2:42-5. Epub 2006 Jun 26.