The case for a National Health Policy…not a national disease policy

Complementary Medicines are a significant component of healthcare.

They are largely funded out of individuals own pockets.

However, the contribution of complementary medicines is rarely recognised by Government. Any economic benefit they could bring is not acknowledged in the current health budget.

There is a growing body of evidence that complementary medicines can reduce the incidence of chronic disease, such as age related eye disease, bone loss and osteoporosis and that they are a lower risk and a more cost effective option for government.

 This was recognised in 2004 by an Expert Committee on Complementary Medicines in the Australian Health System, established by Government following the Pan recall.

 The Committee concluded;

 “Compared with other medicines, some complementary medicines may offer lower risk and more cost effective options for the prevention and treatment of some diseases, conditions and disorders”.

 Blackmores is keen to contribute to the development of health policy as we are of the view that health policy needs to focus not just on the treatment of disease but on health optimisation.  It should ensure public access to affordable complementary medicines that are safe, efficacious and of high quality while respecting freedom of choice and philosophical and cultural diversity.

•          Over 70% of Australians have embraced complementary medicines as part of an integrated strategy of preventative health by using supplements with vitamin, mineral and herbal, natural medicines.

 •          In the last twelve months, 90% of doctors and almost 100% of community pharmacists have recommended vitamins, minerals, fish oil and glucosamine.

 •          Over 50% of Australians would prefer to use a complementary medicine product rather than a pharmaceutical drug.

 •           In 2000, individuals using their own money spent nearly four times as much on complementary medicines and health practitioners as they did on pharmaceuticals.

 •           50% of all healthcare professional visits in 2010 were estimated to be with a complementary healthcare professional.

 •           In some regions of Australia, people visit a complementary healthcare specialist more often than a GP or medical specialist.

 •           Australians spend over $3.5b each year on complementary medicines and therapies, most commonly to assist in the management of chronic disease and improve health and wellbeing.

   •           92% of doctors say they want a better understanding of complementary medicine.

 The cost benefits of complementary medicine – some examples

In 2006 the USA Lewin Group report estimated that if people over the age of 65 increased their daily intake of Omega-3 fatty acids to 1800mg they would reduce the occurrence of heart disease. They also estimated that over a four year period, net savings in hospital expenditure and physician charges would be in the order of US$3.1 billion. The report suggested approximately 384,303 hospitalisations would be avoided.

 In 2010, an Access Economics report from The National Institute of Complementary Medicine (NICM) on the cost effectiveness of complementary medicine reviewed five complementary medicine interventions that each had a reasonable body of evidence for safety and efficacy.  Overall, the review showed complementary medicine to be highly cost effective and highlighted the important role of these products in managing the health of all Australians.  For example, nearly 1.5 million Australians were prescribed antidepressants in 2007-08 at a cost to the government of about 57¢ a day. By comparison St John’s Wort cost consumers an estimated 17¢ a day. 

The health benefits of complementary medicines – some examples

There is a large amount of research now available that shows the use of dietary supplements is effective in preventing and/or treating diseases.

Scientists have found that folic acid supplementation can substantially reduce neural tube birth defects, and a regime of vitamins and zinc can slow the progression of the age-related eye disease, macular degeneration.

A large number of clinical trials have shown that calcium and vitamin D supplements have been found to be helpful in preventing and treating bone loss and osteoporosis and users of cod liver oil were significantly less likely to have depressive symptoms.

The total expenditure for osteoporosis in Australia in 2000-2001 was $221m with $32m contributing to hospital admission costs.

A total of $1.2b was spent on osteoarthritis in 2000-2001 with $567m being spent on hospital services. Procedures associated with osteoarthritis i.e. hip/knee replacements cost between $13,600 and $30,600 per person (and there were 42,000 such procedures carried out in 2003-2004). Scientific evidence has demonstrated that glucosamine sulphate plus chondroitin supplements are able to reduce pain and delay the progression of this condition.

The Government is to be commended for its commitment to refocusing the health system towards prevention. For too long the system has focused on treating people after they become unwell, and this has resulted in vast social and economic costs associated with chronic disease.

By June 2050, 23% of Australians will be aged 65 or more. As the population ages, the cost of healthcare will become the single largest impost on Government.

We applaud the work that has been done recently on the development of the National Preventative Health Strategy. We note its initial focus is on obesity, tobacco and excessive consumption of alcohol and we fully support the goal of Australia becoming the world’s healthiest nation by 2020.

However …

Despite development of the National Preventative Health Strategy and the goal of becoming the world’s healthiest nation by 2020, and despite the widespread and growing use of complementary medicines, there is currently no recognised role for complementary medicine in current health policy development.

Government already recognises and supports supplement use in the context of nutritional intake in food policy and the contribution this makes to the health of Australians and the economy (for example the mandatory fortification of food with vitamins). The government is also committed to research into the potential benefits of ‘nutraceuticals’ and ‘functional food’.

We now call on Government to recognise that complementary medicines provide effective and low-risk prevention/treatment options for healthcare institutions, practitioners and consumers and we welcome the opportunity to engage with Government to pursue true health policy reform.

What we would like Government to support us in achieving

•           CM representation on the Australian National Preventative Health Agency Advisory Council.

•           Greater training of doctors, pharmacists and healthcare professionals to better understand the benefits of complementary medicine and inclusion of developments in complementary medicine as a component in continuing professional development programs.

•           Establishment of an industry consultative committee to advise the Minister for Health and Ageing on the development of Complementary Health Policy.

•           Funding support by Government to continue ongoing research into complementary medicines particularly in relation to its clinical effectiveness and economic contribution.

•           Complementary medicines that have a demonstrable public health outcome and are shown to be cost effective should be made available on a subsidised basis.

•           Removal of GST on those complementary medicines which have a demonstrable public health benefit (such as fish oil, vitamin D and co-enzyme Q10) as has happened with folic acid through inclusion in the GST-free Supply (Health Care) Determination.

•           Inclusion of Blackmores products on the Electronic Health Record in community pharmacies.

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