janice besch - national institute of complementary medicine (nicm) - rise of alternative therapies...

Rise of Alternative Therapies

Push towards preventative health

Alternative Therapies?

• Customary

• Traditional

• Alternative

• Complementary

• Natural

• Integrative

• ‘Not medicine’

Characteristics

• Multiple additional interventions – Medicine, lifestyle, manual therapies

• Tailored to individual needs – person centred

• Multiple end points– Symptom relief

– Reducing disease severity

– Delaying disease progression

– Disease prevention

– Improving quality of life

The Australian Landscape• $3.5Mpa industry

• 2/3 Australians regular users

• Includes all nutritional supplements, herbal medicines, acupuncture, mind-body therapies, manipulative therapies

• National Registration Boards for osteopathy, chiropractic, Chinese medicine

• Ageing population, chronic disease, economic burden

A Growing Sector

• The workforce is growing

– up 80% between 1996 and 2006 compared with population growth at 12% and health professionals overall at 31%

• The number of people consulting practitioners is growing

– Almost doubling over the same time period

Source: ABS Complementary Therapies Report 2008

Trend to Integrative Care

• 30% - 40% of GPs subscribe, administer and use CM• 59% report increasing patient demand• 93% of Victorian GPs reported referring to a CM

practitioner at least once• 62% of GPs surveyed in WA wanted more training• 85% of pharmacists also looked for more training and

information on CM• The Australian Medical Association, the Australian

Medical Council and the Australian College of Nursing support further training and information as well as responsible use of CM

CM Users: A Healthy Profile

• Seeking to manage chronic disease, improve well-being and pursue a preventative healthcare approach

• Exhibit healthier lifestyles, with more exercise, less smoking and better diets

• 73% eat at least minimum daily serves of fruit and vegetables, compared to 54% of the general population

• 42% take CM to address national priority health conditions

Clinical Effectiveness of CM

• The knowledge base for all forms of health intervention is constantly evolving

• Multiple dimensions

– Clinical trials

– Observation

– History of use

• NICM’s work to establish national research priorities for CM provides guidance

About NICM

• Approx 50 academic, professional, HDR students and $3.5-4Mpa

• Bench to bedside capabilities

1. Preclinical studies

2. Clinical trials

3. Research translation and policy

Australia’s only ERA 5 ranked CM Institute –work ‘well above world class’

NICM: HISTORY AND GOVERNANCE

• Operating as a UWS research centre since 2000

• NICM established 2007 by Commonwealth and State Governments as independent agency ($4.6M)

• Hosted and oversighted by UWS

• Diverse funding base

• Now entering a significant expansionary phase

Where to from here?

• Research – the current evidence base is incomplete, and the assessment of complex herbal medicines and multi-component management plans is difficult.

• Evaluation – an agreed method for certifying and supporting safe and efficacious CM use through the private healthcare system

Cost Effectiveness

Frost & Sullivan [US]

“..the use of key dietary supplement ingredients can reduce illness-related hospital utilization costs associated with heart disease, age-related eye

disease, diabetes and bone disease in the United States…”

Access Economics [Aus]

“Four of the five CMs assessed were found to be cost-effective as alternative or adjunctive

treatments for national health priority areas…”

NHMRC funding for CM research

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The NICM Team