A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture

Kim, SY; Lee, H; Chae, Y; Park, HJ

A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture

Kim, SY Lee, H

Chae, Y Park, HJ

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Publication Type:: Journal Article
Citation:: Acupuncture in Medicine, 2012, 30 (4), pp. 273 - 285
Issue Date:: 2012-12-01

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Field	Value	Language
dc.contributor.author	Kim, SY	en_US
dc.contributor.author	Lee, H https://orcid.org/0000-0002-1107-9389	en_US
dc.contributor.author	Chae, Y	en_US
dc.contributor.author	Park, HJ	en_US
dc.date.issued	2012-12-01	en_US
dc.identifier.citation	Acupuncture in Medicine, 2012, 30 (4), pp. 273 - 285	en_US
dc.identifier.issn	0964-5284	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115409
dc.description.abstract	Objective To summarise the evidence on the costeffectiveness of acupuncture. Methods We identified full economic evaluations such as cost-effectiveness analysis (CEA), costutility analysis (CUA) and cost-benefit analysis (CBA) alongside randomised controlled trials (RCTs) that assessed the consequences and costs of acupuncture for any medical condition. Eleven electronic databases were searched up to March 2011 without language restrictions. Eligible RCTs were assessed using the Cochrane criteria for risk of bias and a modified version of the checklist for economic evaluation. The general characteristics and the results of each economic analysis such as incremental cost-effectiveness ratios (ICERs) were extracted. Results Of 17 included studies, nine were CUAs that measured quality-adjusted life years (QALYs) and eight were CEAs that assessed effectiveness of acupuncture based on improvements in clinical symptoms. All CUAs showed that acupuncture with or without usual care was cost-effective compared with waiting list control or usual care alone, with ICERs ranging from 3011/QALY (dysmenorrhoea) to 22 298/QALY (allergic rhinitis) in German studies, and from 3855/QALY (osteoarthritis) to 9951/ QALY (headache) in UK studies. In the CEAs, acupuncture was beneficial at a relatively low cost in six European and Asian studies. All CUAs were well-designed with a low risk of bias, but this was not the case for CEAs. Conclusions Overall, this review demonstrates the cost-effectiveness of acupuncture. Despite such promising results, any generalisation of these results needs to be made with caution given the diversity of diseases and the different status of acupuncture in the various countries.	en_US
dc.relation.ispartof	Acupuncture in Medicine	en_US
dc.relation.isbasedon	10.1136/acupmed-2012-010178	en_US
dc.subject.classification	Complementary & Alternative Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Acupuncture Therapy	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	Randomized Controlled Trials as Topic	en_US
dc.title	A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	30	en_US
utslib.for	1104 Complementary and Alternative Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	30	en_US

Abstract:

Objective To summarise the evidence on the costeffectiveness of acupuncture. Methods We identified full economic evaluations such as cost-effectiveness analysis (CEA), costutility analysis (CUA) and cost-benefit analysis (CBA) alongside randomised controlled trials (RCTs) that assessed the consequences and costs of acupuncture for any medical condition. Eleven electronic databases were searched up to March 2011 without language restrictions. Eligible RCTs were assessed using the Cochrane criteria for risk of bias and a modified version of the checklist for economic evaluation. The general characteristics and the results of each economic analysis such as incremental cost-effectiveness ratios (ICERs) were extracted. Results Of 17 included studies, nine were CUAs that measured quality-adjusted life years (QALYs) and eight were CEAs that assessed effectiveness of acupuncture based on improvements in clinical symptoms. All CUAs showed that acupuncture with or without usual care was cost-effective compared with waiting list control or usual care alone, with ICERs ranging from 3011/QALY (dysmenorrhoea) to 22 298/QALY (allergic rhinitis) in German studies, and from 3855/QALY (osteoarthritis) to 9951/ QALY (headache) in UK studies. In the CEAs, acupuncture was beneficial at a relatively low cost in six European and Asian studies. All CUAs were well-designed with a low risk of bias, but this was not the case for CEAs. Conclusions Overall, this review demonstrates the cost-effectiveness of acupuncture. Despite such promising results, any generalisation of these results needs to be made with caution given the diversity of diseases and the different status of acupuncture in the various countries.

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http://hdl.handle.net/10453/115409