Abstract
ObjectivesThe aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group).MethodsCost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache).ResultsData from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; p<0.0001) with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.ConclusionCompared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.
Highlights
Homeopathy is frequently used by patients in the German healthcare system
Additional homeopathic treatment was associated with significantly higher costs
These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system
Summary
Homeopathy is frequently used by patients in the German healthcare system. A cross-sectional survey representative of the population indicated that 60% of all 1503 persons interviewed had used homeopathy [1] and that 1.97% (n = 7030) of all German physicians specialize in homeopathy [2]. Homeopathy originates from a time when medicine would often do more harm than good [3]. Despite the current lack of valid explanations for the mechanism of action of highly diluted homeopathic remedies [6,10], homeopathy is reimbursed by more than 80 statutory health insurance companies in Germany [11]. In addition to the competition for new insurants, the potential for cost savings is often used by statutory health insurance companies as a relevant argument for reimbursing homeopathy. This cost-saving potential has been supported by several studies that compared homeopathy with conventional medicine [12,13,14]. We observed no differences in costs [15] or additional costs [16,17] in the homeopathic group compared to conventional care depending on the setting or diagnosis
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