Homeopathy: To Make or Not to Make the Economic Case–A Critical Appraisal

Homeopathy has a long tradition in delivering care to patients. Already in the early years of homeopathy in the 19th century, alongside solving the controversies about its mechanisms of action, the matter of costs was considered as an important argument for political decision-makers. This is still the case today, and costs, together with the effectiveness of interventions, are a main parameter used to assess, for example, reimbursability by health insurance companies. This keynote presentation—based on current research—aims at shedding light on this aspect and attempts to use the findings to highlight implications for further research. After an introduction to the terminology of health economics and an overview of the status of the relevant research in integrative medicine, a focus is placed on the study situation in homeopathy. This is done using the results of a systematic review of 21 health economic studies on homeopathy from the past 30 years. Based on an examination of the quality of included studies using the Consensus on Health Economic Criteria (CHEC) List, pitfalls as well as methodological strengths and weaknesses are identified using examples from this review. In addition, the two streams of health economics evident from the review, namely the modelling approach and the classic study based on raw data, are contrasted. We will show that, despite the increased awareness for conducting high-quality clinical trials in homeopathy, health economic evaluations in this area are still fragile in terms of guideline adherence and methodological rigor that harbours the danger of the entire and entirely justified approach being discredited. Based on the positive examples of health economic evaluations, suggestions for a comprehensive methodological framework as to how and why various health economic approaches may be applied to homeopathy in a sound and accurate way are presented, and will conclude this keynote.