Review of economic methods used in complementary medicine

ln spite of the growing body of evidence on the quality and effectiveness of CM, there is a dearth of evidence examining the economics of CM and, in particular., evidence relating to economic evaluation. There are two types of economic evaluation: partial and full. Partial evaluations are limited in scope because they focus on either costs or consequences but not both. Full economic evaluations compare both the costs and the consequences (or outcomes) of competing health care interventions, demonstrate whether the new intervention represents value for money, and present results as an incremental cost-effectiveness ratio that provides policymakers with the information required to justify expenditure decisions. There are three types of full economic evaluation: cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA). All types of analysis use a similar method for measuring and valuing the resources used in an intervention. The social perspective considers resource use from all potential stakeholders such as the government, health care providers and patients themselves. A third player perspective is narrower and considers resources used specifically from the viewpoint of the health care insurer. The distinguishing feature between analyses is how consequences are measured (and valued). In CEA, the consequence is measured in a natural to the intervention (for example, number of urinary tract infections prevented or life years saved). In CUA the consequences is expressed as a more final outcome measure that considers changes to both quality and quantity of life as a result of the intervention. Common utility measures include the quality-adjusted-life-year and the disability-adjusted-life-year. In a CBA, the consequences are measured, and then valued, in monetary terms, with results expressed as a ratio of costs to benefits.