11% of Out-of-Pocket Health Care Spending Goes to CAM
WebMD Health News
Reviewed By Brunilda Nazario, MD
July 30, 2009 -- Americans spend almost a third as much money out-of pocket on herbal supplements and other alternative medicines as they do on prescription drugs, a new government report shows.
Out-of-pocket spending on herbal supplements, chiropractic visits, meditation, and other forms of complementary and alternative medicines (CAM) was estimated at $34 billion in a single year.
The estimate was based on responses to a national health survey conducted in 2007 by the CDC's National Center for Health Statistics (NCHS).
"The bottom line is that Americans spend a lot of money on CAM products, classes, materials and practitioner visits," National Center for Complementary and Alternative Medicine (NCCAM) Director Josephine P. Briggs, MD, said in a media briefing today. "We estimate that this (represents) approximately 11% of the total out-of-pocket spending on health care."
1.5% of Total Medical Costs Involve CAM
Overall out-of-pocket expenditures for complementary and alternative medicines accounted for 1.5% of the $2.2 trillion spent on health care during the year prior to the survey.
Other highlights from the report, released today by NCHS and NCAAM, include:
- In 2007, 38 million adults made an estimated 354 million visits to CAM practitioners, at an estimated cost of almost $12 billion dollars.
- Two-thirds of the out-of-pocket spending was for treatments that did not involve a practitioner, such as over-the-counter herbal therapies and other therapies, classes and materials. About $12 billion was spent on visits to practitioners such as chiropractors, acupuncturists, and homeopathic specialists.
- The biggest single expenditure was for non-vitamin, non-mineral herbal supplements and other products (almost $15 billion) followed by practitioner visits ($12 billion), stretching and meditation-related classes such as yoga, tai chi, and qigong ($4 billion), homeopathic medicines ($2.9 billion) and relaxation techniques ($0.2 billion).
Previously reported figures based on the same national survey showed that 38% of adults and 12% of children under the age of 18 used some type of alternative medicine in 2007.
Acupuncture In, Energy Healing Out
It has been a decade since a nationally representative survey examining expenditures for CAM treatments has been done, but the newly published survey was so different from the old one that researchers were hesitant to compare them.
With that caveat in mind, the data suggest that adults in the U.S. made half as many visits to CAM practitioners in 2007 as they did in 1997, a decline from roughly three visits for every 1,000 adults to 1.5 visits.
Energy-healing therapists and therapists teaching relaxation techniques saw the largest reduction in patient visits.
"Together, the drop in visits to these two groups of practitioners accounted for about half of the total decrease in 2007 from 10 years earlier," the report noted.
A big exception to the decline was acupuncture. Visits to acupuncturists increased from 27 visits per 1,000 adults in 1997 to 79 visits per 1,000 adults in 2007.
"The increase for acupuncture may be in part due to the greater number of states that license this practice and a corresponding increase in the number of licensed practitioners in 2007, compared with 1997, as well as increased insurance coverage for these therapies," the report noted.
It is not clear if visits to chiropractors have increased or decreased over the past decade, the NCCAM's Richard L. Nahin, PhD, told reporters.
Back Pain Big Reason for CAM Use
Chronic pain, especially back pain, is by far the biggest reason that people turn to alternative treatments, Briggs said.
She cited previously released data from the 2007 survey showing that of the top 20 conditions for which CAM treatments are used, nine involve chronic pain.
"Americans turn to treatments like acupuncture, chiropractic care, and massage therapy to deal with these painful conditions," she said, adding that groups like the American College of Physicians and the American Pain Society are on record as endorsing these therapies as useful options for the treatment of chronic back pain.
Briggs said assessing the safety and effectiveness of these and other alternative therapies used to treat chronic pain is a major focus of NCCAM's research efforts.
"I think everyone would agree that we don't know as much as we should, and need to know more, about how to manage back pain," she said.
SOURCES: NCAAM/CDC Report: "Cost of Complementary and Alternative Medicine and Frequency of Visits to CAM Practitioners: 2007." Josephine P. Briggs, MD, director, National Center for Complementary and Alternative Medicine, NIH, Bethesda, MD. Richard L. Nahin, PhD, MPH, acting director, Division of Extramural Research, NCCAM.
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