US CAM spend equals one third of out-of-pocket drug spend

Complementary and Alternative Medicines (CAM) are moving into the mainstream with four out of ten Americans using some form of CAM in 2007 and sales approaching $34bn, according to a US government agency market scan.

This equated to about one third that spent on prescription drugs and about 1.5 percent of the total health care expenditure of $286.6bn, the 2007 National Health Interview Survey found.

CAM practitioner visits equated to about one quarter of physician visits in value.

But Dan Fabricant PhD, interim executive director and CEO at the Washington DC-based Natural Products Association (NPA), said while the figure was high, it could in part be explained by the US insurance system and basic macroeconomics.

“I would imagine that on average a CAM modality is substantially more economical in terms of cost than the cost of out-of pocket pharmaceutical purchases,” he said.

“Because in general there is much less insurance coverage of CAM and virtually none for non-vitamin, non-mineral CAM, we would expect that there are more out of pocket purchases of CAM versus Rx.”

Where the money goes

Of the total $34bn spent on CAM, $14.8bn was used to purchase natural nutritional products such as omega-3 supplements, glucosamine and botanicals such as Echinacea and valerian.

The other $20bn went on CAM products such as essential massage oils, healing classes and materials such as CAM guides, textbooks, meditation mats and crystals.

The survey, developed by the National Institutes of Health's (NIH) National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (NCHS) part of the Centers for Disease Control and Prevention, found Americans spent about one quarter on CAM practitioner visits as they did on physician visits.

"With so many Americans using and spending money on CAM therapies, it is extremely important to know whether the products and practices they use are safe and effective," said director NCCAM director, Josephine P Briggs, MD.

"This underscores the importance of conducting rigorous research and providing evidence-based information on CAM so that health care providers and the public can make well-informed decisions."

In 2007, Americans made about 354m visits to CAM practitioners such as acupuncturists, chiropractors and massage therapists, spending $11.9bn.

"These data indicate that the US public makes millions of visits to CAM providers each year and spends billions of dollars for these services, as well as for self-care forms of CAM," said Richard L. Nahin, PhD, MPH, acting director of NCCAM's Division of Extramural Research and lead author of the cost of complementary and alternative medicine analysis.

Source:

National health statistics reports; no 18.

‘Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007’

National Center for Health Statistics. 2009

Authors: Nahin, RL, Barnes PM, Stussman BJ, and Bloom B. Hyattsville, MD