वैकल्पिक एवं एकीकृत चिकित्सा

Cost-Effectiveness Analysis of Complementary and Alternative Medicine in Treating Anxiety Disorders

Abstract

Matthew Kutch

Objectives: Using survey data, this study produces estimates of the cost, effectiveness, and cost-effectiveness of complementary and alternative medicine combined with traditional therapies (pharmacotherapy and/or psychotherapy) in the treatment of anxiety disorders. Unlike past cost-effectiveness analyses that use a narrow definition or randomized controlled trials, this study uses a broad definition of complementary and alternative medicines and survey data to assess the cost-effectiveness. Study Desi and Outcome Measures: This analysis uses the Medical Expenditure Panel Survey (MEPS), an overlapping panel survey of medical use, expenditure, and health status for the civilian non-institutionalized U.S. population to identity economic costs and effects for individuals with anxiety disorders. The primary measure of effect is based on self-perceived mental health status. Cost-effectiveness is determined by estimation of incremental net benefit method. Potential self-selection bias is investigated using observable characteristics and inverse propensity score weighting. Results: Complementary and alternative medicine users with an anxiety disorder showed a statistically insignificant decrease in costs compared to nonusers ($458.95 versus $467.03; p-value 0.920). Complementary and alternative medicine expenditures were offset by a statistically significant decrease in office-based and pharmaceutical costs. Complementary and alternative medicine users showed an increase in the probability of steady or improved mental health compared to nonusers (0.7549 versus 0.6912; p-value 0.190) resulting in an incremental cost-effectiveness ratio of -$12.70 per 10% increase in the probability of steady or increased mental health. The evidence suggests a high probability that complementary and alternative medicine is cost-effective for large values of effect for anxiety disorders (p-value 0.080 for WTP of $5000). Conclusions: This survey data indicates complementary and alternative medicine users with anxiety disorders had slightly lower costs and improved outcomes. Limitations are considered.