Cost-effectiveness of homeopathy

Health economic research aims to establish a scientific basis for efficient distribution of limited healthcare and financial resources, whilst also ensuring a consistent delivery of high-quality care to patients. The health economic methods used to assess cost-effectiveness of conventional medical treatments can also be applied to homeopathy.

A systematic review considered the highest level of scientific evidence – was published in January 2024, providing an overview of cost-effectiveness studies of homeopathy¹. In all 21 studies included in this review, homeopathy showed similar or better clinical effectiveness compared to the control groups, with a clear positive trend for cost-effectiveness:

^{*2 of these studies were shown to be cost-effective through incremental cost effectiveness analysis.}

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This review¹ by Prof. Thomas Ostermann (Witten/Herdecke University, Germany) included 15 studies examined in a previous 2014 review², plus 6 additional studies. Two independent researchers assessed the quality of the studies using the CHEC list, specifically designed for use with economic evaluations. CHEC scores ranged from 2 to 16 (out of a maximum score of 19): studies published before 2009 had a lower mean score (6.7 ± 3.4) than those published in or after 2009 (9.4 ± 4.3).

It is worth noting that the two most recently published studies included in the review^3,4are among those with the highest quality rating. In addition to a well-chosen study design, both used state-of-the-art economic evaluations. The authors of the updated review stress the importance of maintaining this level of excellence in future economic evaluations of homeopathy.

The highest quality individual cost-effectiveness study⁴ assessed the impact of an ‘over-the-counter’ homeopathic medicinal product, SilAtro-5-90 . A 2017 clinical trial found that using SilAtro-5-90 alongside conventional medicine reduced the recurrence of acute tonsillitis⁵; subsequent economic evaluation found that SilAtro-5-90 also reduced costs (especially when surgery was avoided), compared to treatment with conventional medicine alone.⁴

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A pragmatic randomised clinical trial followed 256 children and adults (aged 6 to 60 yrs) diagnosed with moderate recurrent tonsillitis, over two years. ‘Add-on’ SilAtro-5-90 was found to be clinically effective, reducing the number of acute throat infections, tonsillitis-specific symptoms, and the need for antibiotics when compared to conventional treatment alone.⁵ A subsequent model-based economic evaluation of incremental costs per acute throat infection showed that:⁴

for children under 12, additional SilAtro-5-90 treatment is always cost-effective (regardless of the severity of recurrent tonsillitis), reducing the number of acute throat infections at a lower cost than using conventional treatment alone
for adults and children aged 12 years and older with ‘severe’ recurrent tonsillitis (more than three acute throat infections per year), SilAtro-5-90 helped avoid expensive surgical tonsillectomy.

Further high quality research on the cost-effectiveness of homeopathy is clearly warranted: building on these encouraging findings will determine more definitively whether homeopathy can play a role in managing healthcare costs in future, whilst maintaining levels of clinical effectiveness comparable to existing treatments.

Further information

Cost-effectiveness review (Ostermann et al. 2024 synopsis.

Study evaluating cost-effectiveness of homeopathic treatment for recurrent tonsillitis (Ostermann et al. 2021 synopsis)

Insights into funding of Homeopathy in the UK

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Ostermann T, Burkart J, De Jaegere S, et al. Overview and quality assessment of health economic evaluations for homeopathic therapy: an updated systematic review. Expert Rev Pharmacoecon Outcomes Res, 2024;24:117-142 [PubMed] [FullText]
Viksveen P, Dymitr Z, Simoens S. Economic evaluations of homeopathy: a review. Eur J Health Econ, 2014;15:157-74 [PubMed]
Kass B, Icke K, Witt CM, Reinhold T. Effectiveness and cost-effectiveness of treatment with additional enrolment to a homeopathic integrated care contract in Germany. BMC Health Serv Res, 2020;20:872 [PubMed] [FullText]
Ostermann T, Park A-L, De Jaegere S, Fetz K, Klement P, Raak C, McDaid D. Cost-effectiveness analysis for SilAtro-5-90 adjuvant treatment in the management of recurrent tonsilitis, compared with usual care only. Cost Eff Resour Alloc, 2021;19:60 [FullText]
Palm J, Kishchuk VV, Ulied A, Perotti Fernández J, De Jaegere S et al. Effectiveness of an add-on treatment with the homeopathic medication SilAtro-5-90 in recurrent tonsillitis: An international, pragmatic, randomized, controlled clinical trial. Complement Ther Clin Pract, 2017; 28:181-191 [PubMed]

Resources

Cost-effectiveness of homeopathy

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