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August 04, 2009

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Being able to turn to CAM has saved the conventional medical system way more than $34 billion because it works and helps to prevent people from getting so unwell that they need to be using pharmaceuticals or hospitals.

Working in a retail pharmacy, these numbers do not surprise me. Many people, whether due to cultural beliefs or not, choose to use alternative products instead of the conventional therapies. A lot of the time, it is with the notion that it is safer. However, I always try to tell people that because it is not regulated as much, that they should be a little wary.

Many patients turn to CAM products and are willing to spend out-of-pocket money on them because they very much do not want to be on a prescription medication. Prescription medications (which might be the more economical alternative if they're covered by a patient's insurance), are strongly associated with side effects, interactions and the notion that the patient is unable to care for oneself. People would rather self-manage their medical conditions.

For example, at a hyperlipidemia screening, I met a patient who was taking red yeast rice to lower her cholesterol because she did not want to be on a prescription medication. Imagine her surprise when I told her that the active ingredient in red yeast rice is lovastatin, a prescription medication. Since statins are not benign and require monitoring, I hope that she either discontinued her use of red yeast rice or saw her doctor.

As a renal transplant myself, I am on several medications that cause a number of side effects, such as hypertension and hyperlipidemia, for which I take more medications (a prime example of the prescribing cascade!). Due to these side effects, I am always looking for alternative medications that are just as safe and efficacious as mainstay pharmacotherapy, and so, when I read the statistics in the NHIS survey, I was not surprised at the increasing number of people turning to CAM.

At the same time, I am guilty of not doing the appropriate research about various CAMs and their efficacy, and I can only imagine the number of people who blindly buy these alternative remedies thinking they are ‘better’ than pharmaceuticals. With this being said, I think at some point in the near future, tightened oversight by the FDA will be required with regard to alternative modalities and active participation by healthcare providers will be necessary (actually, it IS necessary now) with medication reconciliation and providing accurate information to patients and consumers.

Complementary and Alternative Medicine (CAM) is definitely becoming more popular with Americans. I worked in a local pharmacy in which the store owner had a very small herbal and natural medicine section. However, she hired a pharmacist that was really interested in CAM, and the small section of the pharmacy has grown to 3 or 4 times the size to accommodate all the herbals and supplements that are now stocked. I have also noticed that a lot more customers come into the store and ask about the different herbal medications. I’m not sure if this is just due to word of mouth or from something they’ve seen on TV or heard on the radio, but one thing is for sure, more people are asking about CAM.

Although for many herbals, it remains to be seen how effective they may be since clinical trials based on herbals are fairly rare. It is important that the author notes that just because products are, “natural,” does not mean that they are all “safe.” Herbal drugs have the potential to do more harm than good since many of them have a lot of drug interactions. A site like Natural Standard is a great resource to find out information regarding CAM.

Wow, those are some shocking stats. Thank you for an interesting read.

In the past few decades the use of complimentary and alternative medicines (CAM) has attracted the companies to do some landmark trials and increase the sale of their agents. As more of these agents are available over-the-counter (OTC), more people are buying them and increasing sales.

CAM is commonly used by adults and the elderly. These days, our elderly population tends to live longer with better control of their diseases, and they are the main consumers of these CAM agents. Now, customers can find an agent for any of their symptoms.

Therefore, as more and more these agents are sold, they are contributing to billions of dollars in CAM sales, and it seems like the trend will continue to go up in future years as well.

I think with this large number of Americans consuming these products, a change in the FDA regulations is needed. Currently, as far as I understand, these supplements are not as strictly regulated like the prescription drugs. A more standardized manufacturing process and final product ingredient check should be considered.

With billions of dollars already spent on CAM in the U.S., I imagine this figure will continue to grow. I have come across numerous people who use alternative methods rather than traditional medicine and have found great success. With more and more attention on these methods, I feel consumers will continue to use these practices, meaning healthcare professionals should address CAM concerns and incorporate this into everyday practice.

In addition, insurance companies will eventually have to address CAM coverage. I'm not sure if this will happen any time soon (although it should), but it is definitely something that should be considered.

Americans spending $34 billion on CAM is certainly no surprise here. This trend has to do with the dissatisfaction of the U.S. healthcare system and the notion that natural products are “safer” than synthetic prescription drugs. However, some of the CAM products are recommended by healthcare practitioners. For instance, fish oil is often recommended for for cardiovascular health and vitamin D plus calcium is recommended for osteoporosis prevention.

CAM products have also become popular as new studies reporting therapeutic and protective benefits of certain herbs are gaining more publicity in the news. I believe that most Americans also take CAM products to prevent certain diseases and promote general health. There is a false sense of security of the idea that natural products are safer. Many prescription drugs are derived from natural sources (i.e. warfarin) and are dangerous when taken in excess of the therapeutic dose. The same precaution may be applied to some natural products.

I have been in a retail pharmacy for about 3 years, and I was amazed to see customers buying complementary and alternate medicines (CAM) left and right. It is quite evident that customers do believe that alternate therapies work, and therefore, they come back to try more. Some agents tend to work better than others. Customers ask many questions about these agents from dosing to side effects and interactions. This is the time when great resources like Natural Standard help healthcare providers answer customers questions about alternative agents. With so many CAM sales each day, I am not surprised by these results.

$34 billion dollars is a lot more than I would have ever guessed! I do agree with the author that information on safety and efficacy of herbal products is very important to avoid any unnecessary harm. That’s the reason I am glad companies like Natural Standard provide evidence-based information on these products and other CAM practices. It makes researching for answers a lot easier.

I am not surprised that Americans spend so much money on complementary and alternative medicine. I know many people who give more credit to allopathic medicine, yet still use several products that fall under the category of CAM. In fact, they do not even consider therapies in this area as medicine, when in fact it is. If not taken correctly and heeding to the warnings concerning adverse effects, dosing, precautions and interactions, there may be serious consequences just as there are in allopathic medicine.

It is a bit concerning to hear CAM thought of as a natural and cheaper. Yes, one does not have the costs of visiting a physician to obtain a prescription, but many of these supplements can cost an exorbitant amount and can have severe effects if not take with great care, not to mention the cost of treating a patient who tried to act as their own diagnostician and failed. I am not saying that natural medicines are not a good option during these hard times; just make sure that as a consumer, you make educated decisions on your treatment based on reliable sources.

The fact that billions are being spent on CAM should send a message to FDA/government. There is little regulation of herbals/supplements, which makes no sense to me, especially since patients are still at risk of adverse events with such agents. There is an incredible need for education and awareness regarding CAM in the U.S. because many people do not research the potential risks of alternative therapies. The need for well-conducted studies is still prevalent, given the amount of people utilizing CAM. We have a long way to go, but slowly, the U.S. is making progress.

I wonder if the Americans surveyed were evenly distributed across the country and how their location affects their view of CAM. California is probably an area where people are more progressive and open about using alternative medicines and therapies. Also, in major cities like Boston or New York, where medical facilities and equipment are state-of-the-art and readily available, physicians and patients may be less likely to consider alternative medicine. I’m not sure if location distribution is something that NHIS takes into consideration, but it would be interesting to see if there is a trend across the country.

I think it would be interesting to compare the numbers of CAM spending worldwide. If America spends $34 billion annually on out-of-pocket CAM, how much does China or Japan spend (seeing as these are areas where many of the CAM therapies were developed)? China has a government-run healthcare system, and I wonder if CAM therapies are covered to a higher degree (and prescription drugs to a lesser one) than they are in America. There are also many differences in physical anatomy between Asians and Americans. Asians typically having a smaller build, and I wonder if this plays a role to the differences (if they do exist) in response to CAM treatment among the nations.

It's not surprising that Americans are spending so much on CAM. With the poor economy, I bet these numbers have increased dramatically over the last year. A lot of people don't have healthcare insurance or can't afford to pay co-pays, so they're turning to natural, cheaper alternatives.

I found it interesting that the article stated that complementary and alternative medicine accounted for a higher percentage of total out-of-pocket healthcare expenditures than it’s percentage of total healthcare expenditures. This is probably because health insurance companies often don’t cover CAM. Although I recently discovered that my insurance company does cover acupuncture and certain other forms of CAM, (which is a step in the right direction) insurance companies still have a ways to go. It will be interesting to see if this coverage changes with all the new healthcare reform changes upcoming.

The fact that Americans are spending so much on CAM is encouraging, but I can see one problem with this study – it relied on Americans to self-report how much money they spent on CAM. The NHIS did not implicate a system to compare what Americans reported they spent with what they actually did spend on CAM, and what I suspect is that Americans probably reported that they go to yoga or buy herbal supplements a lot more than they actually do to sound more health conscious. I know when I go to the doctor’s office, I tend to overestimate the time I spend exercising per week!

I disagree with the reader who stated that if Americans are spending this much money on CAM, then it must be working. I disagree because, as a healthcare professional, I’ve noticed how little part the average American plays in their own healthcare. Most patients will just take advice blindly and don’t even know what it is they are taking and what for.

I encourage patients to ask questions and to always question the decisions their doctors, pharmacists, etc. are making about their care. But the sad truth is that most don’t.

So if a friend of a friend told them some obscure alternative therapy that “worked wonders for them,” I doubt the average consumer would do the research to see if it is truly proven efficacious. They may just blindly take the advice and not ask enough or any questions. And then once they begin taking it, the placebo effect is an amazing thing, and they might honestly think it is working, while it truly is not.

If Americans are willing to spend so much money on something that doesn’t have the efficacy data behind it that proven pharmaceuticals do, it must be working. Retrospective studies and good quality-controlled trials should be conducted in order to determine the actual effect on health and quality of life in patients who turn to CAM rather than or in addition to accepted medical therapies. If there is safety and efficacy behind CAM, then we have the potential to change many aspects of the U.S. healthcare system. Patients would become a bigger part of their own healthcare, quality of life would improve, less money could be spent on pharmaceutical research and manufacturing, new pharmaceuticals could be developed and the combination of CAM plus accepted medical treatments could become the standard of care. Nowadays, Americans will not waste their money. If we continue to see this pattern of spending after 2007 and over the next few years, then it definitely warrants quality investigating.

As the article pointed out, there is an increasing interest and use of CAM therapies in the U.S. People are turning to nutraceuticals and other forms of therapy, such as yoga, meditation and homeopathy, for the prevention and treatment of various conditions. I also think that there is a need for physicians and pharmacists to educate and monitor for safety of nutraceuticals in addition to conventional drug therapies to prevent any interactions and adverse events.

I heard a segment about this report on U.S. spending on complementary and alternative medicine on NPR a few days ago. It brought up an interesting point. The reporters noted that the data for this report were rounded up before the economy fell off a cliff (not his words). This makes you wonder whether people who have lost health insurance as they’ve lost jobs will turn to CAM therapies in greater amounts or fewer? Cost is apparently a big factor, as the reporter noted that different data from the feds said that close to 50 percent of people who use CAM say that traditional healthcare is too pricey for their budgets.

$34 billion dollars out-of-pocket on complementary and alternative medicine?! I wish these people would educate themselves more on the prescription drugs they are taking instead of shelling out so much money on herbal fads. With all this money going into the CAM industry, I am astonished that the FDA still does not regulate it and allows consumers to take all of these various herbal substances, which have not been tested for strength, purity or quality. I agree with Natural Standard, “natural” and “safe” do not mean the same thing, even though it seems like consumers seem to think otherwise.

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