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Expenditures by Consumers on Complementary and Alternative Medicine

Posted Aug 10 2009 4:25pm

I illustrated in a previous note that there is broad overlap between wellness, pre-disease, and complementary and alternative medicine (CAM) (see: Wellness, Preventive Medicine, and the Classic Disease Model ). Complementary medicine can be defined in the following way:

...[C]omplementary medicine is used by conventional medical practitioners to refer to non-invasive, non-pharmaceutical techniques which are used in conjunction with medical treatments such as drugs and surgery. The term implies that conventional medicine is used as a primary tool and the non-invasive, non-pharmaceutical techniques are used as a supplement when needed.

I fully understand that CAM is a broad term and incorporates a number of therapies that may provide few objective health gains such as aromatherapy. However, many of others in the same category such as yoga are now mainstream and provide a large number of tangible benefits. I think that it's important for lab professionals to understand the size of the CAM market and also the role that clinical lab testing may play in it. Below is an excerpt from an article about the topic (see: $33.9 Billion Spent Out-Of-Pocket On Complementary And Alternative Medicine By Americans ) that may be useful in launching this dialogue:

Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine (CAM) over the previous 12 months, according to a 2007 government survey. CAM is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine. CAM accounts for approximately 1.5 percent of total health care expenditures ($2.2 trillion) and 11.2 percent of total out-of-pocket expenditures....Approximately 38 percent of adults use some form of CAM for health and wellness or to treat a variety of diseases and conditions, according to data from the 2007 National Health Interview Survey....Of the $33.9 billion spent on CAM out-of-pocket, an estimated $22.0 billion was spent on self-care costs – CAM products, classes, and materials – with the majority going to the purchase of nonvitamin, nonmineral, natural products ($14.8 billion) such as fish oil, glucosamine and Echinacea. U.S. adults also spent approximately $11.9 billion on an estimated 354.2 million visits to CAM practitioners such as acupuncturists, chiropractors, massage therapists, etc. To put these figures in context, the $14.8 billion spent on nonvitamin, nonmineral, natural products is equivalent to approximately one-third of total out-of-pocket spending on prescription drugs, and the $11.9 billion spent on CAM practitioner visits is equivalent to approximately one-quarter of total out-of-pocket spending on physician visits.

The last sentence here is critical -- CAM accounts for one-third of the total out-of-pocket spending on prescription drugs and one-quarter of total out-of-pocket spending on physician visits. Can this segment of healthcare expenditures be totally ignored by "conventional" medical practitioners, including pathologists and lab professionals, for much longer? But such a statement begs the more important question. In what way can lab professionals provide service to consumers who are using CAM? Two ideas come quickly to mind. The first is the development of reliable quantative assays for the active ingredients in the most popular herbal remedies such as Echinacea. The second is to measure serum analytes and biomarkers to monitor improvements in joint and muscle functions following yoga practice or acupuncture sessions. Early attempts have also been tried to improve the symptoms of Parkinson's disease with yoga, monitored by serum levels of dopamine (see: Moving On with Parkinson's ).

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