Prev Med. 2002 Aug; 35(2): 166-73.

The escalating cost and prevalence of alternative medicine.

MacLennan AH, Wilson DH, Taylor AW.

Department of Obstetrics and Gynaecology, Adelaide University, Women's and Children's Hospital, North Adelaide, South Australia, 5000, Australia. [email protected]

BACKGROUND: The purpose of this study was to measure trends in the prevalence and cost of alternative medicines and alternative practitioner use in an Australian population and to obtain a profile of users and their beliefs. METHODS: In 2000, we repeated a 1993 representative population survey of persons ages 15 years or older living in South Australia, which provided 3,027 personal interviews. We assessed the rates of use, types of alternative medicine and therapists, costs, and beliefs of users and nonusers. Comparisons in usage patterns with the 1993 survey were also made. FINDINGS: In 2000, the overall use of at least one nonmedically prescribed alternative medicine (excluding calcium, iron, and prescribed vitamins) was 52.1% (CI +/- 1.8). Users were more likely to be female, be better educated, have a higher income, and be employed. Since 1993, females were using significantly more herbal medicines, ginseng, Chinese medicines, and aromatherapy oils. Many were self-prescribed. Among users, 57.2% (CI +/- 1.2) did not tell their doctor. In 2000, 23.3% of respondents had visited at least one alternative practitioner with increasing use of acupuncturists, reflexologists, aromatherapists, and herbal therapists. Most thought alternative medicines were safe but thought they were, or should be, subject to the same standards as prescribed medicines. Among respondents, 92.9% wished product information to be of standard and content similar to those supplied with pharmaceuticals. INTERPRETATION: Extrapolation of the costs to the Australian population gives an expenditure on alternative therapies in 2000 of $AUD2.3 billion and for the U.S. population an annual expenditure of $US34 billion. In Australia this represents a 120 and 62% increase in the cost of alternative medicines and therapists, respectively, since 1993. In 2000 expenditure on alternative therapies was nearly four times the public contribution to all pharmaceuticals. The public appears to have ambivalent standards for alternative therapies but wishes to be empowered with accurate information to facilitate self-prescription. The public health ramifications of an expanding alternative medicine industry are great.