Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children.

OBJECTIVES: A pharmacoeconomic study to compare, in terms of: medical effectiveness, quality of life and costs two treatment strategies ('homeopathic strategy' vs 'antibiotic strategy') used in routine medical practice by allopathic and homeopathic GPs in the treatment of recurrent acute rhinopharyngitis in 18-month to 4-year-old children. METHODS: Statistical analysis of data obtained from a population of 499 patients included in a previous 6-month prospective, pragmatic study. The patients were regrouped according to type of drug prescribed. Medical effectiveness was assessed in terms of (i) episodes of acute rhinopharyngitis, (ii) complications, (iii) adverse effects. Quality of life was assessed using the Par-Ent-Qol scale. Direct medical costs (medical consultations, drug prescriptions, prescriptions for further tests) and indirect medical costs (sick-leave) were evaluated from three viewpoints (society, patient, Social Security) using public prices and French Social Security tariffs. RESULTS: The 'homeopathic strategy' yielded significantly better results than the 'antibiotic strategy' in terms of medical effectiveness (number of episodes of rhinopharyngitis: 2.71 vs 3.97, P<0.001; number of complications: 1.25 vs 1.95, P<0.001), and quality of life (global score: 21.38 vs 30.43, P<0.001), with lower direct medical costs covered by Social Security (88 Euros vs 99 Euros, P<0.05) and significantly less sick-leave (9.5% of parents vs 31.6% of parents, P<0.001). CONCLUSIONS: Homeopathy may be a cost-effective alternative to antibiotics in the treatment of recurrent infantile rhinopharyngitis.

Improving the evaluation of homeopathy: economic considerations and impact on health.

OBJECTIVES: The financial crisis of health insurance systems sometimes drives public policy-makers to take precipitate action dominated by economic imperatives. The question addressed here consists in defining homeopathy's scope of intervention, its place in health care strategies, recourse to treatment, and especially economic data appraising homeopathy's impact on expenditures and outlay covered by health insurance in France. METHOD: We used the General Evaluation Model to define the study (to whom is the evaluation made, situations, criteria, measurement of these criteria, quality and precision). RESULTS: The main results are in terms of costs, as follows: * For reimbursable medicines the public sales price of homeopathic products is a quarter of the average. * The total reimbursement for a prescription of allopathic products is three times more than for a prescription of homeopathic products. * Homeopathic physicians incur annual reimbursement outlays which are half those of general practitioners. The differences observed cannot be explained by the patient profile or the diseases treated. Furthermore, a study carried out in France showed that 87% of patients whose physicians had prescribed homeopathic treatment did not see another physician for the same problem. CONCLUSIONS: Once basic analysis has been done, so that the economic and epidemiological impact of a certain health strategy can be determined, it is necessary to proceed further, helping healthcare providers and public authorities to make decisions. Various possibilities exist and should be investigated.

Improving the evaluation of homeopathy: economic considerations and impact on health

The financial crisis of health insurance systems sometimes drives public policy-makers to take precipitate action dominated by economic imperatives. The question addressed here consists in defining... (AU)

[Controlled clinical trial and homeopathic treatment of ORL and recurrent respiratory tract infections in children: preliminary survey of homeopathic physicians]. / Essai clinique contrôlé et traitement homéopathique des infections ORL et respiratoires récidivantes de l'enfant: enquête préliminaire auprès de médecins homéopathes.

We performed a survey to assess the feasibility of a placebo-controlled clinical trial of the treatment of recurrent ENT/respiratory tract infections in children, to assess the diversity of the drugs prescribed, and the acceptability of a clinical trial to homeopathic physicians. A mailed questionnaire was sent to 237 homeopathic physicians, asking for details of prescriptions for 10 consecutive children consulting for ENT/respiratory recurrent infections, and for two simulated cases. We also asked for their opinion about homeopathic treatment evaluation. Only 48 (20 per cent) questionnaires were returned completed. These gave 309 different acute treatments and 422 different preventive treatments for the 10 consecutive patients and 87 different prescriptions for the simulated cases. A total of 467 different drugs were used. The physicians who replied were favourable to the evaluation of homeopathic drugs, reluctant for the use of a placebo; and they would like to receive training in drug evaluation. Setting up a clinical trial in this field would require specific methodological and logistical adaptations, and a detailed training programme for the homeopathic doctors beforehand.