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NICE should recognise 'placebo effect' of complementary therapies

By Nigel Praities

NICE should include benefits from the ‘placebo effect' of complementary therapies such as homeopathy when they assess them for use on the NHS, according to leading think-tank the King's Fund.

Complementary therapies - such as homeopathy - are often criticised as being 'nothing more than placebo', but a King's Fund report now says these effects are important and should be considered during the NICE appraisal process.

Calling for a 'holistic approach' from NICE, the report says complementary therapists often spend longer with patients and ‘maximise the benefits of the setting', and the effect of this is overlooked by the NHS.

‘As long as findings from research can provide confidence in the positive effect of the physical intervention at the heart of the treatment, then any added benefit brought by the therapeutic relationship and the context for treatment should count as part of the treatment effect,' the report says.

‘For complementary therapies such a holistic approach to effectiveness should be adopted by bodies such as NICE, when comparing cost-effectiveness across a range of treatments.'

The controversial proposals come from a heavy-weight panel of independent experts – including former president of the Royal College of Physicians, Dame Carol Black – but have already been criticised as ‘double standards' by one critic.

The report also says new research is needed into complementary therapies, but ‘these do not need to be placebo-controlled as long as they control for the possibility of the patient getting better over time.'

Professor Stephen Holgate, professor of immunopharmacology at the University of Southhampton and one of the report's authors said: ‘As scientists, we have often sneered at the placebo effect. But as doctors, we know it can have a real impact on the outcomes of treatment for our patients.'

But Professor Edzard Ernst, professor of complementary medicine at Peninsula Medical School in Exeter, said: ‘This is the introduction of double standards through the back door.'

‘In this case we might as well allow an ineffective medication on the market, because it too will have a placebo effect.'

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