Viksveen Petter, Dymitr Zofia, Simoens Steven
School of Health and Related Research, University of Sheffield, Sheffield, UK,
Eur J Health Econ. 2014 Mar;15(2):157-74. doi: 10.1007/s10198-013-0462-7. Epub 2013 Feb 10.
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.
To review and assess existing economic evaluations of homeopathy.
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.
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.
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.
在资源有限的时代,需要对顺势疗法等常用补充和替代医学(CAM)疗法进行经济学评估,以为政策制定者、临床医生、医疗保健支付方以及患者做出医疗保健决策提供证据基础。
回顾和评估现有的顺势疗法经济学评估。
通过使用AMED、Cochrane图书馆、CRD(DARE、NHS EED、HTA)、EMBASE、MEDLINE以及《顺势疗法杂志》(前身为《英国顺势疗法杂志》)检索相关出版物。对手头相关出版物进行了检索。联系了顺势疗法研究人员。两位作者对已识别的出版物进行了独立评估。
15篇相关文章报道了14项顺势疗法经济学评估。13项研究报告了患者数量:共有3500名患者接受了顺势疗法治疗(中位数97,四分位间距48 - 268),10项研究报告了对照组参与者情况(中位数57,四分位间距40 - 362)。14项研究中有8项发现患者健康状况改善且成本节约。4项研究发现顺势疗法患者的改善情况与对照组患者相当,成本相近。2项研究发现改善情况与传统治疗相似,但成本更高。研究具有高度异质性且存在若干方法学弱点。
尽管已识别的关于顺势疗法成本和潜在益处的证据似乎很有前景,但研究具有高度异质性且存在若干方法学弱点。因此,不可能基于现有的顺势疗法经济学评估得出确凿结论。本文提出了对未来研究的建议。