Anthroposophic Medicine
Effectiveness, Utility, Costs Safety
Gunver Kienle MD*, Helmut Kiene MD*, Hans Ulrich Albonico, MD*
*) Reviewers, Institute für Applied Epistemiology and Medical Methodology IFAEMM, Schauinslandstrasse 6, DE-70189 Bad Krozingen.
E-Mail: gunver.kienle@ifaemm.de, helmut.kiene@ifaemm.de   

**) Expert for research in the field of anthroposophic medicine, Vereinigung Anthroposophisch Orientierter Ärzte in der Schweiz (VAOÄS), Bernstrasse 13, CH-3550 Langnau, E-Mail: albolem@hotmail.com 

©2006 by Schattauer Verlag, Stuttgart-New York (Schattauer GmbH, Hölderlinstrasse3, DE-70174, Stuttgart, Germany). 
ISBN-10: 3-7945-2495-0
ISBN-13: 978-3-7945-2495-2
  

The present Health Technology Assessment (HTA) report (http://www.bag.admin.ch  www.ifaemm.de) was commissioned by the Swiss Federal Social Insurance Office and produced as part of the national Complementary Medicine Evaluation Programme (PEK).

The presented review is an update of this HTA-report, providing an overview of the available scientific literature on the effectiveness, utility, costs and safety of anthroposophic medicine.

Content 
Studies 
Results: effectiveness 
Results utility 
Results safety 
Results costs 
Conclusions 
Content
Introduction 

Presentation of the special aspects of anthroposophic medicine, in basic research and  clinical practice 

Discussion of the methodology 

Material and methods 

Results with regard to Effectiveness, utility, costs and safety 

Discussion 

Comment on presented criticism regarding studies with mistletoe 

Catalogue of case presentations and Literature not used for the analysis etc. 

Studies 
Single case studies (not analysed in the review): 2090 studies

Clinical studies suitable for analysis: 195 studies

Systematic reviews in 4 "Domains": 127 studies

Further studies "Appendix": 68 studies

Design of the 195 studies

       Prospective comparative design: 40 studies

           RCTs: 18 studies (5 blinded)

           Matched-Pair: 4 studies (3 blinded)

       Retrospective comparative design: 45 studies

       Cohort-study design: 110 studies

             prospective: 62 studies

             retrospective: 43 studies

                other: 5 studies


Results: effectiveness
127 Studies in 4 “Domains”

Anthroposophic Medicine studied as a therapeutic system for various disorders (including comparisons of systems) 
8 studies 
Treatment of pain or treatments of wounds with anthroposophic medicines 
18 studies including 3 RCTs 
Non-pharmacologic treatment of various disorders 
5 studies and 3 extra-analyses 
Anthroposophic mistletoe treatment of cancer
96 studies including 15 RCTs 
68 studies further studies ("Appendix")

Chronic hepatitis B or C 
10 studies 

Neurological or psychiatric disorders 
7 studies 

Gynecology and Obstetrics 
6 studies 

Acute infections (upper respiratory tract, ear, eyes, gastrointestinal) 
18 studies 

Circulatory diseases 
6 studies 

Thyroid diseases 
4 studies 

Pulmonary diseases (sarcoidosis) 
6 studies 

Other disorders 
11 studies 

Results: summary 4 Domains and Appendix
195 studies were analysed:

186 studies had positive results for the AM-Group (similar or better result compared to conventional therapy regarding at least 1 clinical parameter). 
8 studies showed neither positive nor negative results. 
1 study showed a negative trend. 
The practical relevance was throughout the studies high. 
The quality of the studies varied from very to good to very poor (in particular the retrospective comparative studies). 
The satisfaction of the patients was high. 
The positive results were still relevant, if the analyses was restricted to the qualitative good studies.

Results utility:
Users of anthroposophic medicine:

patients of basic national health care and patients with special intentions 

especially women, patients aged 30-50 years and children 

high educational level 

often after complications or ineffectiveness of conventional treatment 

intention for comprehensive treatment and active engagement 

high grade of satisfaction of the patients with AM 

Results safety:
2 carefully designed safety analyses, phase I-studies, questionnaires within the framework of clinical studies, register, case reports 

good compliance 

0.005% of the applications of medicines caused slight side effects 

In general, AM had higher compliance and less side effects, if compared to conventional medicine. 

Results costs:
Within the framework of PEK the cost analysis was done in general and not diffentiated for the different therapies. 

Only very few cost analyses are available specifically for anthroposophic medicine. 

1 German study, which was performed in 141 offices of anthroposophic medical doctors, including 898 patients treated with anthroposophic medicines for chronic diseases showed less costs during the study year, if compared to those during the year before enrolling into the study (3.484 Euro vs. 3.637 Euro). 

The patients treated with anthroposophic medicine had less costs for medicines and less referrals to hospital care, although the severity of their disorders was similar or even worse, if compared to the conventionally treated group. 

Conclusions:
Anthroposophic medical therapies result in favourable clinical outcomes according to the large majority of the reviewed studies. This conclusion also holds when limited to studies with good quality. 

Anthroposophic medicine is used by both, patients within ordinary health care provision and by patients with special intention for this therapeutic approach. 

Anthroposophic medical therapies are satisfactory to the patients and safe. 

Anthroposophic medical therapies may also be cost effective through lower rates referrals to hospital-treatment and lower costs for medication particular in chronic diseases.