English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

In his recent editorial [1] David M. Shaw drew attention to a book on the effectiveness, appropriateness, safety and costs of homeopathy that had recently been published in English [2]. He pointed out several shortcomings regarding good research practice. Unfortunately, several statements in the editorial, concerning the role the Swiss government had in publishing the report, as well as the influence the book supposedly had on the latest decision on coverage of homeopathy by the mandatory Swiss health insurance, are not correct. Since the editorial is supposed to contribute to improving standards of conducting and publishing systematic reviews and Health Technology Assessments (HTAs), we feel that it is important that this obviously erroneous piece of information is rectified. In order to do this adequately, a short summary of the history preceding the latest decision concerning coverage is necessary: Mandatory health insurance in Switzerland offers coverage only for services that are in accordance with the Swiss health insurance law. The following criteria must be fulfilled: “Wirksamkeit” (efficacy/effectiveness), “Zweckmässigkeit” (appropriateness / comparative effectiveness / risk-benefit-ratio), and “Wirtschaftlichkeit” (price level / cost impact / cost-effectiveness). In 1998, the former minister of the department of Home Affairs (health matters and health insurance are regulated in this department) decided that homeopathy and four other methods of complementary and alternative medicine (CAM) can be covered under two conditions, the first condition being that services are covered only if provided by physicians licensed for independent practice and who have undertaken postgraduate training in the respective method approved by the Swiss Medical Association. The second condition was that efficacy, effectiveness, appropriateness and cost impact had to be evaluated within 6 years. Similar “coverage under evaluation” schemes have been applied since 1996 in Switzerland for promising technologies when it was yet unclear if they fulfilled the criteria mentioned above. Later this concept was described and discussed under the term “coverage with evidence development” or CED in the international scientific literature [3]. The Swiss government financed an evaluation programm (Programm Evaluation Komplementärmedizin PEK) consisting of literature reviews, descriptive studies of CAM practice in Switzerland, and an analysis of the Swiss Health Surveys 1997 and 2002 on the utilisation of CAM. In May 2005, the main results of the evaluation were made available and presented to the commission that advised the ministry concerning coverage decisions. In June 2005 the minister made the decision to end any existing coverage of the five CAM methods [4] and on the same day, the final report was made available as an e-publication. Further publications or abstracts produced within PEK as well as critical comments of the international scientific review board to the final phase of PEK were added to the website at a later point [5]. As far as homeopathy is concerned, two literature reviews were commissioned: A meta-analysis on homeopathy trials and of matched trials in conventional medicine [6], and a broad analysis of the literature incorporating publications and unpublished reports on studies of various methodologies (randomised and non-randomised trials, case series, experimental studies). This review was declared to be an HTA by the authors (the final PEK [5] report does not classify the literature reviews as HTA reports) and published later as a book [7] under their responsibility without any consent of the Swiss government or administration. The book by Bonhöft and Matthiessen was later translated into English and published in 2012 [2]. The decision to end coverage for homeopathy and other CAM methods in 2005 was strongly criticised by large parts of the population even beyond the (according to the Swiss Health Survey 2002 [5]) 11% CAM users, and by many politicians. The decision also led to a referendum aiming at promoting CAM in general. The intention behind

The report “Homeopathy in healthcare: effectiveness, appropriateness, safety, costs” is not a “Swiss report”