Official Swiss Government Study and Report Dramatically Affirms Homeopathy’s Positive Results, Safety and Cost Effectiveness

A new study and report by the Swiss Government has been published in an English book form.  It is the most comprehensive study of homeopathy undertaken  by a government.  As reported on Huffington Post the report is the most significant and largest study of homeopathy ever undertaken.

“The Health Technology Assessment report on effectiveness, cost-effectiveness and appropriateness of homeopathy was compiled on behalf of the Swiss Federal Office for Public Health (BAG) within the framework of the ‘Program of Evaluation of Complementary Medicine (PEK)”.

After carefully monitoring homeopathic treatment in Switzerland and also taking an extensive overview of all scientific studies of homeopathy it concludes that “taking internal and external validity criteria into account, effectiveness of homeopathy can be supported by clinical evidence and professional and adequate application be regarded as safe”(PubMed).  They concluded that homeopathic treatment should continued to be reimbursed by Switzerland’s national health insurance program.

“The Swiss government’s “Health Technology Assessment” on homeopathic medicine is much more comprehensive than any previous governmental report written on this subject to date. Not only did this report carefully and comprehensively review the body of evidence from randomized double-blind and placebo controlled clinical trials testing homeopathic medicines, they also evaluated the “real world effectiveness” as well as safety and cost-effectiveness. The report also conducted a highly-comprehensive review of the wide body of preclinical research (fundamental physio-chemical research, botanical studies, animal studies, and in vitro studies with human cells).

And still further, this report evaluated systematic reviews and meta-analyses, outcome studies, and epidemiological research. This wide review carefully evaluated the studies conducted, both in terms of quality of design and execution (called “internal validity”) and how appropriate each was for the way that homeopathy is commonly practiced (called “external validity”).

After assessing pre-clinical basic research and the high quality clinical studies, the Swiss report affirmed that homeopathic high-potencies seem to induce regulatory effects (e.g., balancing or normalizing effects) and specific changes in cells or living organisms. The report also reported that 20 of the 22 systematic reviews of clinical research testing homeopathic medicines detected at least a trend in favor of homeopathy.* (Bornhöft, Wolf, von Ammon, et al, 2006)

The Swiss report noted that the Shang team [who authored the Lancet meta-analysis] did not even adhere to the QUORUM guidelines which are widely recognized standards for scientific reporting (Linde, Jonas, 2005).

Dana Ullman MPH on Huffington Post

Two New Studies Disprove Lancet’s Anti-Homeopathy Conclusions

Two new studies conclude that a review which claimed that homeopathy is just a placebo, published in The Lancet, was seriously flawed.  

George Lewith, Professor of Health Research at Southampton University comments: The review gave no indication of which trials were analysed nor of the various vital assumptions made about the data. This is not usual scientific practice. If we presume that homeopathy works for some conditions but not others, or change the definition of a ‘larger trial’, the conclusions change. This indicates a fundamental weakness in the conclusions: they are NOT reliable.’

The background to the ongoing debate is as follows:

In August 2005, The Lancet then published an editorial entitled ‘The End of Homeopathy’, prompted by a review comparing clinical trials of homeopathy with trials of conventional medicine.  The claim that homeopathic medicines are just placebo was based on 6 clinical trials of conventional medicine and 8 studies of homeopathy but did not reveal the identity of these trials.  The review was criticised for its opacity as it gave no indication of which trials were analysed and the various assumptions made about the data. When Lancet was questioned about the study’s manipulation of data and the proclaimed anti-homeopathy bias of the individual who did the study, Egger, the editors responded, “We were aware of Dr. Eggers bias prior therefore it was accepted.”

Sufficient detail to enable a reconstruction was eventually published and two recently published scientific papers based on such a reconstruction challenge the Lancet review, showing that:

·       Analysis of all high quality trials of homeopathy yields a positive conclusion. 

·       The 8 larger higher quality trials of homeopathy were all for different conditions; if homeopathy works for some of these but not others the result changes, implying that it is not placebo.

·       The comparison with conventional medicine was meaningless. 

·       Doubts remain about the opaque, unpublished criteria used in the review, including the definition of ‘higher quality’.

 

The Lancet review, led by Prof Matthias Egger of the Department of Social and Preventive Medicine at the University of Berne, started with 110 matched clinical trials of homeopathy and conventional medicine, reduced these to ‘higher quality trials’ and then to 8 and 6 respectively ‘larger higher quality trials’.  Based on these 14 studies the review concluded that there is ‘weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions’.

 

There are a limited number of homeopathic studies so it is quite possible to interpret these data selectively and unfavourably, which is what appears to have been done in the Lancet paper.  If we assume that homeopathy does not work for just one condition (Arnica for post-exercise muscle stiffness), or alter the definition of ‘larger trial’, the results are positive.  The comparison with conventional medicine was meaningless: the original 110 trials were matched, but matching was lost after they were reduced to 8 and 6.  But  the quality of homeopathic trials was better than conventional trials.

This reconstruction casts serious doubts on the review, showing that it was based on a series of hidden judgments unfavourable to homeopathy.  An open assessment of the current evidence suggests that homeopathy is probably effective for a number of conditions including allergies, upper respiratory tract infections and ‘flu, but more research is desperately needed.

Prof Egger has declined to comment on these findings.