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Homeopathy 4 Everyone - Editorial |
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| March, 2006 | ||||
Busting The Lancet & The PEK Study- Dr. Manish Bhatia |
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Dear Readers, In the last few months, the Lancet article denouncing homeopathy as placebo evoked a lot of emotion in the homeopathic community. With time, more details about the study and the article have been brought to light and I am pleased to share those details with you. Do you know that the Lancet-article was based on an isolated part of the Swiss PEK (Programms Evaluation Komplementärmedizin /Program for Evaluating Complementary Medicine) studies? The PEK studies were organized and financed by Swiss government to get the scientific base for a decision concerning CAM (Complementary/Alternative Medicine). It turns out, that the results of the studies were too good (in favour of CAM) - so the politicians chose to completely ignore the PEK-study at the end ...and came to a negative decision! Here is the summary of the Swill PEK Report: Background: Following the decision taken by the Federal
Department of Home Affairs (DHA) on 9 July 1998, five complementary
therapies – anthroposophical medicine, homeopathy, neural
therapy, phytotherapy and traditional Chinese medicine (more precisely,
traditional The decision on whether these complementary
methods should be retained within the basic health insurance scheme
is dependent on their efficacy, appropriateness and cost effectiveness
being demonstrated. To this end, the Complementary Medicine Evaluation Design of the PEK: A basic procedure was defined, comprising two parts. In Part 1 (evaluation of the provision of complementary medicine for patients in Switzerland), empirical studies were to be carried out, permitting conclusions as to: (a) how prevalent the five therapies are
in Switzerland, For points b, c, and e, comparisons were made with conventional medicine. On account of methodological and time-related problems, however, point d could not be evaluated. In Part 2 (literature analysis), the literature available internationally on efficacy, appropriateness (here primarily defined in terms of safety and utilization) and cost-effectiveness was to be systematically compiled and reviewed.
In 2002, 10.6% of the Swiss population had recourse to at least one of the five complementary therapies, with homeopathy being the individual method most frequently mentioned (stress mine). Practitioners of complementary medicine can be distinguished from physicians providing conventional healthcare with regard to the nature, location and technical resources of their practice. The patients they treat tend to be younger, female and better educated. These patients tend to have a favourable attitude towards complementary medicine and to exhibit chronic and more severe forms of disease. Technical diagnostic procedures are performed more rarely, and patients’ wishes are taken into account more frequently in the choice of treatment. On average, the consultation lasts markedly longer than in conventional care. Patients are more satisfied with the care provided (stress mine) in practices offering complementary medicine. Side effects are reported by markedly fewer patients (stress mine) than with conventional care – with the exception of phytotherapy. With complementary medicine, the total annual costs are markedly lower than the average for conventional care (stress mine). Overall, however, complementary practitioners treat fewer patients, and more frequently younger and female patients. Adjusted for these factors, the total patient-related costs do not differ significantly from those for conventional care. The cost structure is characterized by a greater weighting for consultation costs and a lower weighting for drug costs. The actual increase in costs resulting from the inclusion of the five complementary therapies in Switzerland’s basic healthcare provision proved to be markedly lower than expected (stress mine). On the basis of the statistics produced by the PEK, the question of whether complementary medicine should be regarded as being utilized in addition to or, rather, instead of conventional care cannot be definitively answered. Results of the literature analysis The analysis of the literature involved two different projects. (1) For each of the five complementary therapies,
a comprehensive overall evaluation (evaluation report) was prepared.
As regards the first project, the assessment of efficacy was favourable in all of the evaluation Reports (stress mine). For phytotherapy and homeopathy in particular, this was based on the evaluation of published systematic reviews and randomized clinical studies. In the case of traditional Chinese herbal therapy, while numerous randomized studies of Chinese origin exist, they are scarcely available in Western countries. In the view of the evaluation committee, the interpretation of the available evidence on efficacy in the evaluation reports appears to be overly optimistic for all of the methods reviewed, and especially for neural therapy. The safety of all five therapies is favourably assessed (stress mine), with certain reservations in the case of neural therapy and traditional Chinese herbal therapy. Data concerning utilization are only available for complementary medicine as a whole; for many countries, the uptake is shown to be high and still increasing (stress mine). As regards the second project, in the view of the authors of the meta-analyses, the available placebo-controlled studies on homeopathy do not demonstrate any clear effect over and above placebo. For phytotherapy, in contrast, a positive result is shown, as in the evaluation report, and for traditional Chinese herbal therapy an unequivocal assessment is not possible. Here, too, the validity of the conclusions of the meta-analyses should be regarded as limited from a methodological perspective. ------------------------------------------------------- As fas as that meta-analysis is concerned, I have already shown in my previous article ‘Homeopathy, Research & The Lancet’ that the meta-analysis is biased and full of short comings. To read the full article, click here. But this is not all. The whole phenomenon of setting up the PEK, and issuing of its report was highly political. If you want to find out the extent to which political setup and conventional medicine can go to hamper the growth of homeopathy and complementary medicine, read the following (not very well translated report) from an insider who was part of this whole PEK process: Medizin und Macht am Beispiel des Programms Evaluation Komplementärmedizin PEK This is in German. You can read an English version (machine translation) here - Medicine and power at the example of the programme Evaluation <-- READ THIS More about this report from Dr Ton Nicolai, ECH, President Decision of the Swiss authorities Although homeopathy and other CAM therapies proved to be cost-effective and may save millions of Swiss Francs on the health budget, the Swiss government decided to exclude all CAM therapies from the compulsory health insurance scheme as from 30 June 2005, much to the dissatisfaction of the CAM. The Swiss authorities – both the government and the National Health Office (BAG) – initially tried to sweep the results of the PEK study under the carpet. A conference scheduled for April 2005 to present and discuss the results of the PEK study had to be cancelled because the National Health Office suppressed the publication of the study data. Some collaborators were even coerced into deleting all PEK related data from their computers. A final meeting of the international Review Board of 6 professors from Switzerland, Germany, Denmark and the UK – responsible for the scientific quality of the PEK study – to be held in June 2005 for a final assessment of the project, was cancelled. The recommendation in the final draft that homeopathy, anthroposophical medicine and herbal medicine should stay in the compulsory health insurance scheme was deleted in the final publication (stress mine). Later on the government allowed some reports to be put onto the BAG website and the data files to be available for perusal at the BAG office in Bern. The report by the SVHÄ concerning homeopathy,
can be found at http://www.dzvhae.com/portal/pics/abschnitte/030605064159_antrag_svha.pdf The report on the PEK study (in German) can be downloaded at: I request all of you to forward this letter to everyone you know, so that more and more people can find out about this conspiracy against homeopathy and alternative medicine. Let us raise our collective voice against such efforts to hamper the growth of homeopathy. Send me your feedback, opinion and views at editor@hpathy.com Yours sincerely,
-- Chief Editor -- |
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