NHS England wants to stop prescriptions for ‘low value’ medicines and some think homeopathy should be on that list. Steve Mann, director of external regulatory affairs at Nelsons, has other ideas…
Homeopathic remedies are still going to be available on prescription on the NHS, as well as OTC in pharmacies, and the continuation of NHS funding for this form of therapy doesn’t sit well with some. But there are many advocates of homeopathy in the healthcare system, not to mention amongst patients as well, and NHS England and the Royal Pharmaceutical Society should also listen to their voices.
The membership of the Faculty of Homeopathy is made up of registered healthcare professionals such as doctors, nurses, dentists and vets. They have trained for many years to gain their qualifications and are trusted and respected members of the healthcare community, to whom the public can turn when they have health issues or concerns.
They include homeopathy in their practice and believe it provides benefit for their patients, often as part of an integrated approach to healthcare. Such well-trained and knowledgeable experts have earned the right to prescribe what they feel is the best course of action when treating their patients and sometimes a homeopathic prescription may be part of that treatment.
But what does ‘low value’ mean with respect to homeopathy? We’ve seen a subtle shift in terms of how medical treatments are regarded in recent times, not only considering efficacy, but also the cost effectiveness of treatment.
What might this mean for homeopathic therapies? The members of the Faculty of Homeopathy, pharmacists and patients might argue that homeopathic treatments are far from being low value and can, in fact, provide cost-effective treatment for a number of self-limiting conditions.
Efficacy is, of course, of great significance in evaluating treatment options and pathways. But the efficacy of many treatments we might regard as tried and tested aren’t necessarily what we might expect. In 2003, Dr Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline and a pre-eminent figure in the field, stated that drugs for cancer only work for one in four patients, while drugs for migraines, osteoporosis and arthritis are only effective about 50% of the time. In fact, more than 90% of drugs only work in 30-50% of people. Perhaps not the kind of statement you might expect from a pharmaceutical executive.
An analysis of 1,016 systematic reviews of RCTs of conventional medicine also demonstrates results that might surprise many.
The findings showed: 44% were positive – the treatments were likely to be beneficial; 7% were negative – the treatments were likely to be harmful; and 49% were inconclusive – the evidence did not support either benefit or harm.
Research has also demonstrated that some SSRI anti-depressants may work no better than placebo for mild and moderate depression, yet in 2006 the NHS spent £150 million on SSRIs. So the picture of low value, treatment efficacy and cost effectiveness may be more complicated than it first appears.
Believe it or not, you don’t have to look too far to find data from healthcare settings which supports the effective use of homeopathic treatments. A few examples of positive studies include:
– The largest study at Bristol Homeopathic Hospital followed over 6,500 consecutive patients with over 23,000 attendances in a six-year period – 70% of follow-up patients reported improved health; 50% reported major improvement.
– A 500-patient survey at the Royal London Homeopathic Hospital showed that many patients were able to reduce or stop conventional medication following homeopathic treatment.
A major French study managed by LA-SER, a UK-based company specialising in scientific evidence for medicine and health technologies, followed 8,559 patients attending GP practices using homeopathic treatment. The two key findings were:
– Patients with upper respiratory tract infections treated by GPs trained in homeopathy did as well clinically as those treated with conventional medicine but used fewer conventional drugs.
– Patients with musculoskeletal disorders treated with homeopathy did as well clinically as those treated with conventional medicine but used only half the amount of non-steroidal anti-inflammatory drugs (NSAIDs) and had fewer NSAID-related side effects.
In terms of how much the therapy costs the health service, one of the biggest benefits of homeopathy is the low cost of treatment. In the UK last year, the total NHS drug budget was £15.5 billion and it only spent £94,000 (0.0006%) on homeopathic prescriptions.
Out of the total NHS budget of £130 billion, it spent only £5 million (0.004%) on the whole homeopathic service, covering everything from the running costs of hospital departments to paying the doctors.
Given the complexity of the picture surrounding treatment efficacy, whatever that treatment may be, its value and cost effectiveness, it perhaps isn’t that surprising that homeopathy wasn’t considered such a ‘low value’ medicine by the NHS after all.
Pharmacists received approximately 9,000 homeopathic prescriptions last year which their patients would undoubtedly expect them to be able to dispense. Today’s consumers are well-informed and have an expectation of their pharmacy to stock a large range of healthcare products.
This includes all kinds of natural healthcare products for minor self-limiting conditions. These can include herbal medicines, vitamins, minerals, food supplements, botanicals, cosmetics and homeopathic remedies.
OTC products play an important role in modern healthcare as customers become more proactive with their physical and mental well-being. Pharmacists can support their customers by understanding how these treatment options can help and how they may work in conjunction with conventional therapies.
Nelsons has always strongly advocated an integrated approach to health, with complementary and conventional medicine working alongside each other to provide the best outcome for patients.
We believe that everyone should have access to reliable information on their treatment options so they can make informed choices about their healthcare.