Complementary medicine represents an additional cost to usual care with questionable clinical benefit

More doubts are cast over the cost effectiveness of complementary medicine in this week's British Medical Journal.

The cost-effectiveness of using complementary treatments in the United Kingdom has been the subject of much speculation and controversy.

For instance, a report commissioned by the Prince of Wales last week said that complementary therapies should be given a greater role in the NHS, while others believe that more studies are needed before they are made widely available.

As an example of how poor the evidence is, researchers carried out a systematic review of cost effectiveness analyses of complementary treatments. They found only five studies done in the UK before April 2005, one of acupuncture for headache and four of spinal manipulation for back pain.

They conclude that these treatments represent an additional cost to usual care with questionable clinical benefit.

In an accompanying editorial, two senior doctors and general practice researchers suggest that complementary medicine should be considered for inclusion in national clinical guidelines despite limited evidence of cost effectiveness.

They believe that the integration into the NHS of specific complementary therapies for chronic conditions would be beneficial to patients, but that each therapy needs to be considered on its merits, including cost-effectiveness.