The Swiss Government has reviewed a significant body of evidence, and determined that homeopathy both works and is considerably more cost effective than conventional medicine. It confirms a view widely held in many German-speaking parts of Europe, that homeopathy offers a valuable addition to the conventional and complementary medical landscape.
The results of the Swiss Health Technology Assessment (HTA) report on homeopathy were published in English at the end of last year. Entitled ‘Homeopathy in Healthcare’, and edited by Dr Gudrun Bornhöft and Prof. Peter Matthiessen, it is part of the Swiss Government’s 1998 ‘Complementary Medicine Evaluation Programme’ (PEK). This was set up to evaluate homeopathy and other complementary an alternative medicine (CAM) therapies for their ‘efficacy, appropriateness and cost effectiveness’.
Furore over interpretation of PEK studies
The HTA report fully vindicates homeopathy after the massive furore and much comment in 2005, on completion of the PEK study. The PEK report (summary only, in English), produced 2 years before the planned completion of the HTA report, included results of the much smaller quantitative sub-study of the homeopathy project, which had evaluated experimental trials. Despite the fact that the homeopathy reviews indicated: ‘effectiveness likely’—the top category on a 3-tier scale, and studies on a particular indication (upper respiratory tract infections/allergy) indicated ‘probable effectiveness’, the overall conclusion of the sub study was that the evidence had demonstrated ‘no significant difference to placebo’ for homeopathic treatment (Shang et al, 2005). A Lancet editorial followed, declaring ‘The end of homeopathy’, and skeptics went into overdrive with scathing attacks on homeopathy, which, in the UK, led to the farcical Science and Technology Sub-Committee’s so-called: ‘Evidence Check: Homeopathy’ sessions.
More comprehensive
The much more comprehensive HTA is an established scientific procedure that not only examines efficacy, but also examines ‘real-world effectiveness’, appropriateness, safety and economy. In contrast to the subsidiary sub-study result, which was considered ‘of little relevance for the political decision’, the HTA found that ‘the individual CAM interventions, especially homeopathy, were effective, under Swiss conditions safe and, as far as could be judged from the trial situation, also cost efficient’.
One can only wonder how long it will be before governments, such as the UK’s, that has been susceptible to pressure from the vehemently anti-homeopathy skeptic movement, will approach assessments with this kind of openness and objectivity?
Comments
your voice counts
09 May 2012 at 9:58 pm
It is interesting that the EU pushes Conventional medicine and argues against Natural Medicine.
Conventional medicine has proven itself to be dangerous and ineffective.
M
12 May 2012 at 12:17 pm
Thank goodness for a truthful article about that Swiss government report!
You will find it here http://www.zenosblog.com/2012/05/that-neutral-swiss-homeopathy-report/
15 May 2012 at 4:11 pm
Hi Jem, thanks for your comment. Just a couple of quick questions, if we may. First of all, why are you so convinced that the article you link to is “truthful”? What we have in this “truthful” article is an English translation – by a confirmed homeopathy skeptic [ https://twitter.com/#!/svenrudloff ] – of a previously unavailable report [ http://www.bag.admin.ch/themen/krankenversicherung/00263/00264/04102/index.html?lang=de&download=NHzLpZeg7t,lnp6I0NTU042l2Z6ln1acy4Zn4Z2qZpnO2Yuq2Z6gpJCDdIR8e2ym162epYbg2c_JjKbNoKSn6A-- ] that we are told contradicts the findings of the Swiss Health Technology Assessment (HTA). It is important to remember that the actual data we have available to us are: the full HTA report into homeopathy [ http://www.springerlink.com/content/978-3-642-20638-2#section=949782&page=6&locus=0 ]; its summary report [ http://content.karger.com/produktedb/produkte.asp?DOI=10.1159/000093586 ]; the flawed [ http://anhinternational.org/news/homeopaths-get-front-foot ] Shang et al meta-analysis [http://www.ncbi.nlm.nih.gov/pubmed/16125589?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum]; and the overall summary report of the Programm Evaluation Komplementärmedizin (PEK) [ http://www.bag.admin.ch/themen/krankenversicherung/00263/00264/04102/index.html?lang=de&download=NHzLpZeg7t,lnp6I0NTU042l2Z6ln1acy4Zn4Z2qZpnO2Yuq2Z6gpJCDdIR8e2ym162epYbg2c_JjKbNoKSn6A-- ] investigation of several natural modalities, including homeopathy, which has been translated by Mr Rudloff and published on Zeno’s Blog. The health economic data, the PEK survey data and the data for therapies other than homeopathy are all unpublished, meaning that we cannot examine the information upon which the PEK based their conclusions – which have, in turn, been used as the basis of the Zeno’s Blog piece.
Which brings us to our second question. Aren’t we simply witnessing how the same data can receive widely differing interpretations, depending on who’s doing the interpreting? On the one had, we have the HTA report into homeopathy, which – if we assume the authors of the HTA and the accompanying summary report [ http://content.karger.com/produktedb/produkte.asp?DOI=10.1159/000093586 ] were the same, which seems sensible – looks to have been written by qualified and experienced practitioners of both natural and orthodox healthcare. On the other, we have the PEK summary of the individual reports into all the natural therapies investigated by the Swiss government, including homeopathy, which was written by a panel of orthodox medics, a health economist, a naturopath and two, er, lawyers.
Bearing this in mind, it hardly seems surprising that the HTA report came out more favourably for homeopathy than the overall PKA report. Actually, we can’t say that: all we can say is that the panel tasked with reviewing the entirety of the PKA data drew more negative conclusions than the homeopathy HTA report itself! The following comment [ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375230/ ] from the PEK's international review board may shed some further light on the matter: "There is a consensus among the review board members that the final PEK process deviated from what would have been expected by conventional standards. Especially disconcerting was the fact that the products of the PEK process — health technology assessment (HTA) reports, single description of studies, manuscripts for publication and the condensed final report — were sent to the board members but no discussion, comment, or review was solicited by the responsible agencies."
In the end, the Zeno’s Blog piece does what skeptics do best: it muddies the water by adding yet another interpretation to data that most people won’t have either the time or the inclination to review themselves. The HTA report was highly positive about homeopathy, and lo and behold, there’s a skeptic article to say that homeopathy is nothing more than sugar pills, witchcraft and confidence tricks. It’s as predictable as the sunrise but with the opposite effect, of clouding things rather than illuminating them.
It sounds rather like the whole process is about to be repeated, with a new HTA in the offing and a re-analysis of the original PEK data. We await the inevitable bickering with a sinking heart. It’s clear that homeopathy is dear to the hearts of many thousands of Swiss and millions more people worldwide, not because of what randomised, controlled clinical trials say, but because of clinical effects that they experience themselves when they take homeopathic remedies. What’s needed, therefore, to answer the vexed question of homeopathic efficacy is a form of ‘outcome-based medicine’ – or OBM, which we see as the natural successor to evidence-based medicine (EBM) – that measures clinical outcomes among patients taking, and not taking, homeopathy. If the Swiss government was proposing a double-controlled, observational trial of homeopathy versus standard medical care, and another of homeopathy versus placebo, looking at how patients progress in the manner that real-life clinical relationships occur, we’d be among the first to applaud. Unfortunately, it sounds like a recipe for more of the same.
17 May 2012 at 10:07 pm
Thank you for your response. I'll take your questions one by one.
1. "Why are you so convinced that the article you link to is “truthful”?"
Well, I know it's truthful because I checked out the all-important details and they turned out to be true.
To be specific, Zeno's article points out that as a result of the final report, the Swiss Government decided NOT to allow statutory reimbursement for homeopathy (and other alternative therapies) after June 2005 but that, because a public referendum endorsed the use of CAM, the Swiss Government has given it a temporary reprieve, giving the various therapies until 2015 to come up with evidence of efficacy and cost effectiveness. I find it strange, you don't mention any of this in your news story.
2. "Aren’t we simply witnessing how the same data can receive widely differing interpretations, depending on who’s doing the interpreting?"
Indeed we are! The relevant data in this instance is that the Swiss Government has given homeopathy until 2015 to prove it works and is cost effective. Apologists for CAM will no doubt agree with your interpretation of this as the "Swiss Government finds homeopathy effective and cost efficient". The rest of us will interpret it as meaning homeopathy has three years to prove itself.
I sense we have differing interpretations of the word 'truthfulness', as well.
By the way, as a courtesy to your readers, you might learn to embed links properly.
22 May 2012 at 1:52 pm
So you haven't published my last response to you. I don't blame you as it must be embarrassing to learn that you've been rumbled. It's OK, I found a better place to post it. Love the response, LOL.
http://www.skepticat.org/2011/12/an-alliance-of-playground-bullies/#comments
22 May 2012 at 4:41 pm
Hi Jem, sorry for not replying instantly but we’re a small team and very busy! No need to call ‘censorship’ just yet. We’re also looking into embedding links, so thanks for your suggestion.
We weren’t disputing the outcome in Switzerland in terms of reimbursement. Our point was that the HTA report on homeopathy was highly favourable, and that a subsequent multimodality report written largely by doctors and lawyers was less positive.
We stand by our interpretation that this affair is a clear demonstration that people who use homeopathy in the clinical setting to treat patients are highly positive about it, while people schooled in more orthodox methods are virulently anti-homeopathy. Never the twain will meet, it seems, especially when those on the other side of the debate dismiss the two-thirds of the Swiss population who voted for natural healthcare in the referendum as ‘apologists for CAM’.
Since you didn’t mention it, would you care to respond to our suggestion of a way forward for deciding the effectiveness of homeopathy, using a form of ‘outcome-based medicine’? We suspect it won’t be discussed at Skepticat’s place.
19 July 2012 at 1:04 pm
Lets hope they have made the right decision
18 July 2013 at 8:34 am
To test homeopathy, you have to know each patient. Homeopathic doctors take at least an hour on the first consultation to get to know what sort of person they are dealing with. It is ridiculous to give 'n' people the same homeopathic remedy in order to prove/disprove that they work. One remedy will certainly not be effective on all of those tested. There is no such thing as ONE REMEDY FOR ALL in this discipline.
When will a homeopathic doctor stand up and say this.... double-blind testing is rubbish in this context.
Large drug companies are paying out millions to keep homeopathics from being believed and accepted. We, the genuine users of them KNOW they work - have proved it ourselves. It is complex. Animals and children are the proof for most purposes.
23 July 2015 at 12:17 pm
To do a scientific survey of whether homeopathy works, surely the METHOD of TREATMENT should be tested and not the efficacy of an individual remedy.
If it is necessary to compare the efficacy of homeopathy versus chemical pharmaceuticals used by allopathic practitionars, then a group of people with a specific clinically identified condition e.g. diabetes should be chosen and the METHODS of treatments should be compared. If allopaths choose to use a single remedy, it is their choice. The study group should then divided into two groups where an equal amount of patients with similar profiles e.g. age, general condition of health, weight etc. Then over a period of 5 years these people should be treated by a homeopath / group of homeopaths and a single or group of doctors using synthetic chemical medicines. The study can be monitored by a group of scientist with equal numbers from both groups as well as medical scientist who are truly independent from both modalities.
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