What Insurance Records Say About Homeopathy in France

Map of FranceAn analysis of insurance records in the national system in France yielded the following: Of all that nation’s healthcare professionals, 43% prescribed at least one homeopathic as a covered service between July 2011 and June 2012. For general practitioners, dermatologist, and pediatricians, the finding was 95%. For midwives, 75% prescribed homeopathics. In more than half of all cases (55%), regular medicines were co-prescribed.

The target populations were typically children and women, although at least 10% of the entire population—6,705,420 patients—received at least one prescribed homeopathic. Of total “drug units” prescribed in France in that 12-month period, 5% reflected homeopathic preparations. The article, with Michel Piolota as lead author, is entitled “Homeopathy in France in 2011-2012 according to reimbursements in the French national health insurance database.”

Comment: These data are interesting in the midst of the furor over homeopathy in Australia following publication of a controversial governmental report lambasting the field as having zero scientific support— and also in the context of the current re-examination of homeopathic regulation in the United States. (See Homeopathy on Trial (Again): Australian Report and Now USFDA April 20-21 Hearings.) Notably, the use appeared to be bi-modal, with a third having received only one homeopathic prescription and more than 50% having received three or more. Interesting to see how many were co-prescribed regular pharma. Makes one wonder about how rigid the adherence was to what a practitioner might have urged as optimal compliance for taking either type of medication.

This usage data underscores how critically important “grandparenting” is in defining what products, practices, drugs, and procedures of all types are included in a given insurance scheme, whether public or private. While homeopathic medications won’t typically pass through the eye of an insurer’s evidence needle, routine conventional practices wouldn’t fare much better. For instance, a University of Pittsburgh Medical Center leader recently opined that “only about a quarter of what we do has strong evidence and we only do that half the time.” In lieu of evidence-based medicine (EBM) we have CBM (“culturally based medicine”) or perhaps HBM (“historically based medicine”). Once we have that, we have the real-world practice of IBM (“insurance-based medicine”): what is best is defined by what is covered by insurance.

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