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Complementary Medicine Evaluation Programme

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In 1998, the Swiss government began a comprehensive Program for Evaluating Complementary Medicine PEK : Programm Evaluation Komplementärmedizin = Program for Evaluating Complementary Medicine to study the role and effectiveness of complementary medicine, which was playing an ever-increasing role in the Swiss medical system

According to the PEK Report, results of the evaluation were inconclusive, and in June 2005, the five complementary therapies under evaluation - anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine more precisely, traditional Chinese herbal therapy - were removed from the list of services covered by the compulsory health insurance scheme KLV

Contents

  • 1 Summary of the PEK Report
    • 11 Background
    • 12 Design of the PEK
    • 13 Outcomes
  • 2 Notes and references
  • 3 See also

Summary of the PEK Report

The complete text of the 24 April 2005 version of the "Programm Evaluation Komplementärmedizin" Report, also referred to as PEK, "Program for Evaluating Complementary Medicine" and "Complementary Medicine Evaluation Programme", is available from the Swiss Parliament website and also from the Swiss Federal Office of Health BAG PEK download webpage

The official data is available in German and French from the Swiss Federal Office of Public Health BAG data download page

Background

Following the decision taken by the Swiss 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 Chinese herbal therapy - were included on 1 July 1999 for a limited period until 30 June 2005 in the list of services covered by the compulsory health insurance scheme KLV These five services were only eligible for reimbursement if they were provided by physicians who had the relevant proficiency certificates, issued by the Swiss Medical Association FMH

The decision on whether these complementary methods would be retained within the basic health insurance scheme was to be based on their efficacy, appropriateness and cost-effectiveness being demonstrated To this end, the Complementary Medicine Evaluation Programme PEK was carried out from 1998 to 2005

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, b which physicians offer these therapies, c which patients have recourse to them, d what results are achieved with these treatments, and e what impact these therapies have on costs

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

Outcomes

Part 1 was carried out by a team from the Panmedion Foundation, a pro-CAM think tank The results were not published in the peer-reviewed literature but an expanded version was separately published an translation as "Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs" This paper, promoted by homeopathy supporters as a "Swiss government report" was strongly criticised and characterised as "a case study of research misconduct" due to undeclared conflicts of interest, reversal of the normal hierarchy of evidence and other concerns, prompting Dr Felix Gurtner of the Swiss Federal Office of Public Health to disown its purported status

Part 2 was published in The Lancet as Are the clinical effects of homoeopathy placebo effects Comparative study of placebo-controlled trials of homoeopathy and allopathy

The terms-of-reference for the PEK study stated that the results of the study would determine which complementary medicines, if any, would continue to be supported by the national insurance program in Switzerland However, before the study was completed and the final draft report reviewed by the international Review Board, the government announced that it would withdraw support for all complementary approaches to medicine

Proponents of CAM including the scientific director of the program were dissatisfied with the outcome

Both reports were given reduced weight

Following a referendum in which the authors of the Part 1 report acted as proponents, reimbursement was reinstated for a further trial period of 5 years from 2012

Notes and references

  1. ^ a b Complete text of the official PEK report In German, with summaries in German, French, Italian and English Accessed June 2007
  2. ^ a b German Language Wikipedia page for Bundesamt für Gesundheit BAG
  3. ^ Various PEK related documents, mostly in German, but some also in French, Italian and English, including the report on the PEK study can be downloaded from the Swiss Federal Office of Health BAG PEK download page Accessed August 2007
  4. ^ BAG Health Insurance Statistic Reports download page In German and French Accessed August 2007
  5. ^ The Swiss Report on Homeopathy, Steven Novella, Science Based Medicine, 2012-06-27
  6. ^ The Swiss Government's Remarkable Report on Homeopathic Medicine, Dana Ullman, Huffington Post 2012-02-15
  7. ^ A critique of the Swiss report Homeopathy in Healthcare, Ernst, E, Focus on Alternative and Complementary Therapies FACT Volume 17, Issue 3, pages 160–162, September 2012
  8. ^ Shaw, DM, "The Swiss Report: A case study of research misconduct", Swiss Med Wkly 2012;142:w13594
  9. ^ The report “Homeopathy in healthcare: effectiveness, appropriateness, safety, costs” is not a “Swiss report”, Felix Gurtner, Swiss Med Wkly 2012;142:w13723
  10. ^ Are the clinical effects of homoeopathy placebo effects Comparative study of placebo-controlled trials of homoeopathy and allopathy Shang A, Huwiler-Müntener K, Nartey L, Jüni P, Dörig S, Sterne JA, Pewsner D, Egger M Lancet 2005 Aug 27-Sep 2;3669487:726-32
  11. ^ Unipublic Zurich University Archived 27 May 2006 at the Wayback Machine Accessed August 2007
  12. ^ Peter Fisher, Homeopathy and the Lancet from "Evidence-Based Complementary and Alternative Medicine", 2006 31:145-147 Online at OxfordJournalsorg Archived 20 August 2008 at the Wayback Machine Accessed August 2007
  13. ^ Walach H, Linde K, Eichenberger R, Stalder H, Kristensen FB, Kleijnen J Summary Consensus Statement of the PEK Review Board regarding the PEK process and the PEK products, 27 September 2005 English and German versions available from the BAG PEK download page Accessed August 2007
  14. ^ Dacey J 14 January 2011 "Alternative therapies are put to the test" swissinfoch Retrieved 2011-04-24 
  15. ^ "Swiss recognise 'alternative' medicine – for now" 

See also

  • Healthcare in Switzerland

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    29.10.2014


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