BMJ  2007;334:600 (24 March), doi:10.1136/bmj.39156.570208.FA

Letters

NICE on CAM

Appraisals of specific treatments are needed

In debating whether the National Institute for Health and Clinical Excellence (NICE) should evaluate complementary and alternative medicine (CAM), neither side cites the two recent systematic reviews showing the cost effectiveness of certain treatments in certain conditions.^{1 2 3 4}

Fourteen exemplary studies indicated that the following CAM therapies may be considered cost effective compared with usual care: acupuncture for people with migraine; manual therapy for people with neck pain; spa therapy for people with Parkinson's disease; self administered stress management for patients with cancer undergoing chemotherapy; preoperative and postoperative oral nutritional supplementation for patients undergoing lower gastrointestinal tract surgery; biofeedback for patients with "functional" disorders such as irritable bowel syndrome; and guided imagery, relaxation therapy, and potassium rich diet for patients with heart disease.^{3 4} Last year, acupuncture for chronic low back pain was added to the list.⁵ All these interventions are safe and popular with patients. Is it relevant that the only thing they don't do is transform the NHS budget into pharmaceutical company profits?

Institute of Health and Social Care Research, Peninsula Medical School, Exeter EX1 2LU

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Competing interests: None declared.

References

1. Franck L, Chantler C, Dixon M. Should NICE evaluate complementary and alternative medicine? BMJ 2007;334:506. (10 March.)[Free Full Text]
2. Colquhoun D. Should NICE evaluate complementary and alternative medicine? BMJ 2007;334:507. (10 March.)[Free Full Text]
3. Canter PH, Coon JT, Ernst E. Cost effectiveness of complementary treatments in the United Kingdom: systematic review. BMJ 2005;331:880-1.[Free Full Text]
4. Herman PM, Craig BM, Caspi O. Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med 2005;5:11.[CrossRef][Medline]
5. Wonderling D. Acupuncture in mainstream health care. BMJ 2006;333:611-2.[Free Full Text]

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