Exclusive: The paradigm and application of clinical research in traditional Chinese medicine

Exploring the significant value of health economics evaluations acupuncture for international promotion

  • ZENG Dian ,
  • GUO Ran ,
  • LIU Yuanli ,
  • HE Liyun ,
  • LIU Baoyan
Expand
  • 1. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100700, China;
    2. School of Health Policy and Management, Peking Union of Medical College, Beijing 100010, China

Received date: 2024-05-18

  Revised date: 2024-08-02

  Online published: 2024-12-14

Abstract

As health economics methods have been widely adopted for developing clinical guidelines and adjusting health policies in the word, the advantages of acupuncture—being simple, convenient, effective, and affordable—urgently need scientific validations through health economics evaluation methods.This paper reviews published health economics articles on acupuncture and summarizes the progress and characteristics of current evaluations in this field.It also analyzes the reasons for low homogeneity and limited number of studies in acupuncture health economics evaluations.These reasons include the scarcity of long-term follow-up data from randomized controlled trials (RCTs) and real-world data in acupuncture clinical research, limited assessments of quality of life, and significant cost differences across countries and regions.The paper suggests further efforts to improve the development of acupuncture health economics guidelines, standardize research methods, and strengthen construction and training in related disciplines.By exploring the cost-effectiveness of acupuncture, its attractiveness and acceptance in the global health field can be enhanced, so as to provide strong support for the international promotion of acupuncture and its integration into mainstream medical systems.

Cite this article

ZENG Dian , GUO Ran , LIU Yuanli , HE Liyun , LIU Baoyan . Exploring the significant value of health economics evaluations acupuncture for international promotion[J]. Science & Technology Review, 2024 , 42(21) : 170 -179 . DOI: 10.3981/j.issn.1000-7857.2024.05.00461

References

[1] 谢依璇, 闫世艳, 陈波, 等. 新时代针灸的发展[J]. 科技导报, 2023, 41(14): 42-50.
[2] 郭然, 曾典, 胡裕涵, 等. 价值医疗视角下的中医药优势评价思路与方法[J]. 科技导报, 2023, 41(14): 14-21.
[3] 闫世艳, 熊芝怡, 刘晓玉, 等. 2010—2020年针灸临床研究现状及展望[J]. 中国针灸, 2022, 42(1): 116-118.
[4] Lu L M, Zhang Y Q, Tang X R, et al. Evidence on acupuncture therapies is underused in clinical practice and health policy[J]. British Medical Journal, 2022, 376: e067475.
[5] Sanders G D, Neumann P J, Basu A, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses[J]. Journal of the American Medical Association, 2016, 316(10): 1093.
[6] Gold M R, Siegel J E, Russell L B, et al. Cost-effectiveness in health and medicine[M]. New York: Oxford University Press, 1996.
[7] Peter J N, Theodore G G, Louise B R, et al. Cost-Effectiveness in Health and Medicine[M]. 2nd ed. New York: Oxford University Press, 2016.
[8] Anderson J L, Heidenreich P A, Barnett P G, et al. ACC/ AHA statement on cost/value methodology in clinical practice guidelines and performance measures: A report of the American college of cardiology/American heart association task force on performance measures and task force on practice guidelines[J]. Journal of the American College of Cardiology, 2014, 63(21): 2304-2322.
[9] US Preventive Services Task Force, Grossman D C, Curry S J, et al. Screening for ovarian cancer: US preventive services task force recommendation statement[J]. Journal of the American Medical Association, 2018, 319(6): 588-594.
[10] Neumann P J, Sanders G D. Cost-effectiveness analysis 2.0[J]. New England Journal of Medicine, 2017, 376(3): 203-205.
[11] Goldie S J, Yazdanpanah Y, Losina E, et al. Cost-effectiveness of HIV treatment in resource-poor settings— The case of Côte d'Ivoire[J]. New England Journal of Medicine, 2006, 355(11): 1141-1153.
[12] Goldhaber-Fiebert J D, Stout N K, Salomon J A, et al. Cost-effectiveness of cervical cancer screening with human papillomavirus DNA testing and HPV-16, 18 vaccination[J]. JNCI: Journal of the National Cancer Institute, 2008, 100(5): 308-320.
[13] NICE. The national institute for health and care excellence[EB/OL]. (2024-01-01)[2024-02-27]. https://www. nice.org.uk/.
[14] Li H C, Jin X J, Herman P M, et al. Using economic evaluations to support acupuncture reimbursement decisions: Current evidence and gaps[J]. British Medical Journal, 2022, 376: e067477.
[15] Lu L M, Zhang Y Q, Ge S Q, et al. Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies[J]. British Medical Journal Open, 2022, 12(6): e056803.
[16] Xue C C, Zhang A L, Lin V, et al. Acupuncture, chiropractic and osteopathy use in Australia: A national population survey[J]. BMC Public Health, 2008, 8(1): 105.
[17] Thomas K, Coleman P. Use of complementary or alternative medicine in a general population in Great Britain. Results from the National Omnibus survey[J]. Journal of Public Health, 2004, 26(2): 152-157.
[18] Bleck R, Marquez E, Gold M A, et al. A scoping review of acupuncture insurance coverage in the United States[J]. Acupuncture in Medicine, 2021, 39(5): 461-470.
[19] Zeng D, Yan X X, Deng H M, et al. Placebo response varies between different types of sham acupuncture: A randomized double-blind trial in neck pain patients[J]. European Journal of Pain, 2022, 26(5): 1006-1020.
[20] Madsen M V, Gøtzsche P C, Hrobjartsson A, et al. Acupuncture treatment for pain: Systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups[J]. Deutsche Zeitschrift Für Akupunktur, 2010, 53(2): 40-41.
[21] Wonderling D, Vickers A J, Grieve R, et al. Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care[J]. British Medical Journal, 2004, 328(7442): 747.
[22] Witt C M, Jena S, Selim D, et al. Pragmatic randomized trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain[J]. American Journal of Epidemiology, 2006, 164(5): 487-496.
[23] Ratcliffe J, Thomas K J, MacPherson H, et al. A randomised controlled trial of acupuncture care for persistent low back pain: Cost effectiveness analysis[J]. British Medical Journal, 2006, 333(7569): 626.
[24] Willich S N, Reinhold T, Selim D, et al. Cost-effectiveness of acupuncture treatment in patients with chronic neck pain[J]. Pain, 2006, 125(1): 107-113.
[25] Witt C M, Reinhold T, Brinkhaus B, et al. Acupuncture in patients with dysmenorrhea: A randomized study on clinical effectiveness and cost-effectiveness in usual care[J]. American Journal of Obstetrics and Gynecology, 2008, 198(2): 166.e1-166.e8.
[26] Witt C M, Reinhold T, Jena S, et al. Cost-effectiveness of acupuncture treatment in patients with headache[J]. Cephalalgia, 2008, 28(4): 334-345.
[27] Reinhold T, Witt C M, Jena S, et al. Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain[J]. The European Journal of Health Economics, 2008, 9(3): 209-219.
[28] Witt C M, Reinhold T, Jena S, et al. Cost-effectiveness of acupuncture in women and men with allergic rhinitis: A randomized controlled study in usual care[J]. American Journal of Epidemiology, 2009, 169(5): 562-571.
[29] Kim N, Yang B, Lee T, et al. An economic analysis of usual care and acupuncture collaborative treatment on chronic low back pain: A Markov model decision analysis[J]. BMC Complementary and Alternative Medicine, 2010, 10(1): 74.
[30] Whitehurst D G T, Bryan S, Hay E M, et al. Cost-effectiveness of acupuncture care as an adjunct to exercisebased physical therapy for osteoarthritis of the knee[J]. Physical Therapy, 2011, 91(5): 630-641.
[31] Deng Z Q, Zheng H, Zhao L, et al. Health economic evaluation of acupuncture along meridians for treating migraine in China: Results from a randomized controlled trial[J]. BMC Complementary and Alternative Medicine, 2012, 12(1): 75.
[32] Reinhold T, Roll S, Willich S N, et al. Cost-effectiveness for acupuncture in seasonal allergic rhinitis: Economic results of the ACUSAR trial[J]. Annals of Allergy, Asthma & Immunology, 2013, 111(1): 56-63.
[33] Taylor P, Pezzullo L, Grant S J, et al. Cost-effectiveness of acupuncture for chronic nonspecific low back pain[J]. Pain Practice, 2014, 14(7): 599-606.
[34] Spackman E, Richmond S, Sculpher M, et al. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: The results of the ACUDep trial[J]. PLoS One, 2014, 9(11): e113726.
[35] Toroski M, Nikfar S, Mojahedian M M, et al. Comparison of the cost-utility analysis of electroacupuncture and nonsteroidal antiinflammatory drugsin the treatment of chronic low back pain[J]. Journal of Acupuncture and Meridian Studies, 2018, 11(2): 62-66.
[36] Nicolian S, Butel T, Gambotti L, et al. Cost-effectiveness of acupuncture versus standard care for pelvic and low back pain in pregnancy: A randomized controlled trial[J]. PLoS One, 2019, 14(4): e0214195.
[37] Molassiotis A, Dawkins B, Longo R, et al. Economic evaluation alongside a randomised controlled trial to assess the effectiveness and cost-effectiveness of acupuncture in the management of chemotherapy-induced peripheral neuropathy[J]. Acupuncture in Medicine, 2021, 39(1): 41-52.
[38] Liu Z Z, Huang J, Xu Y, et al. Cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for communitybased patients with Broca's aphasia after stroke: A post hoc analysis of data from a randomised controlled trial[J]. British Medical Journal Open, 2021, 11(9): e046609.
[39] Wen H, Wei X J, Ge S Q, et al. Clinical and economic evaluation of acupuncture for opioid-dependent patients receiving methadone maintenance treatment: The integrative clinical trial and evidence-based data[J]. Frontiers in Public Health, 2021, 9: 689753.
[40] Oberoi D V, Longo C J, Reed E N, et al. Cost-utility of group versus individual acupuncture for cancer-related pain using quality-adjusted life years in a noninferiority trial[J]. The Journal of Alternative and Complementary Medicine, 2021, 27(5): 390-397.
[41] Skonnord T, Fetveit A, Skjeie H, et al. Cost-effectiveness analysis of acupuncture compared with usual care for acute non-specific low back pain: Secondary analysis of a randomised controlled trial[J]. Acupuncture in Medicine, 2022, 40(2): 123-132.
[42] Zhao W X, Huang H M, Liu K, et al. Acupuncture and moxibustion for peripheral neuropathic pain: A frequentist network meta-analysis and cost-effectiveness evaluation[J]. Evidence-Based Complementary and Alternative Medicine, 2022, 2022: 6886465.
[43] Kim S Y, Lee H, Chae Y, et al. A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture[J]. Acupuncture in Medicine, 2012, 30(4): 273-285.
[44] Duarte R V, Lambe T, Raphael J H, et al. Intrathecal drug delivery systems for the management of chronic noncancer pain: A systematic review of economic evaluations[J]. Pain Practice, 2018, 18(5): 666-686.
[45] 周雪忠, 王世华, 张迪, 等. 构建中医药特色真实世界临床研究新模式的实践与思考[J]. 科技导报, 2023, 41(14): 22-31.
[46] Kim J J, Burger E A, Regan C, et al. Screening for cervical cancer in primary care: A decision analysis for the US preventive services task force[J]. Journal of the American Medical Association, 2018, 320(7): 706-714.
[47] 上海市卫生健康委员会. 国家中医药局就上海建设国家中医药综合改革示范区情况举行发布会(实录全文)[EB/OL]. (2023-10-13)[2024-02-27]. https://wsjkw. sh. gov.cn/gzdt1/20231012/343f6f964df9460aa19f9a674cd2- 61b0.html.
Outlines

/