Economic Evaluation of Complementary and Alternative Medicine in Oncology: Is There a Difference Compared to Conventional Medicine?
OBJECTIVE
To analyze the financial burden of complementary and alternative medicine (CAM) in cancer treatment.


METHODS
Based on a systematic search of the literature (Medline and the Cochrane Library, combining the MeSH terms 'complementary therapies', 'neoplasms', 'costs', 'cost analysis', and 'cost-benefit analysis'), an expert panel discussed different types of analyses and their significance for CAM in oncology.


RESULTS
Of 755 publications, 43 met our criteria. The types of economic analyses and their parameters discussed for CAM in oncology were cost, cost-benefit, cost-effectiveness, and cost-utility analyses. Only a few articles included arguments in favor of or against these different methods, and only a few arguments were specific for CAM because most CAM methods address a broad range of treatment aim parameters to assess effectiveness and are hard to define. Additionally, the choice of comparative treatments is difficult. To evaluate utility, healthy subjects may not be adequate as patients with a life-threatening disease and may be judged differently, especially with respect to a holistic treatment approach. We did not find any arguments in the literature that were directed at the economic analysis of CAM in oncology. Therefore, a comprehensive approach assessment based on criteria from evidence-based medicine evaluating direct and indirect costs is recommended.


CONCLUSIONS
The usual approaches to conventional medicine to assess costs, benefits, and effectiveness seem adequate in the field of CAM in oncology. Additionally, a thorough deliberation on the comparator, endpoints, and instruments is mandatory for designing studies.
Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Frankfurt, Germany.
Jutta
J
Huebner
Franz J
FJ
Prott
Ralph
R
Muecke
Christoph
C
Stoll
Jens
J
Buentzel
Karsten
K
Muenstedt
Oliver
O
Micke
D000529:Complementary Therapies / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics; D006801:Humans; D009369:Neoplasms / Q000191:economics / Q000628:therapy*; D000072103:Oncologists / Q000191:economics