Federal government investigates homeopathy funds – researchers: “No scientific basis”

German Health Minister and physician Karl Lauterbach no longer wants homeopathy to be paid for by health insurers. Homeopathy is not a service that offers medical benefits based on scientific facts, the SPD politician said in Berlin. The goal is to save 20 to 50 million euros annually.

It’s not about the money, it’s about the principle. To be reimbursed, scientific evidence of effectiveness must be provided, which is not the case. Payment for homeopathic and anthroposophic treatments should be stopped to avoid “unnecessary health insurance costs”.

Lauterbach’s plans appeal to molecular biologist Beda Stadler. “There has never been a scientific basis for the effectiveness of homeopathy,” says the former director of the Institute for Clinical Immunology at the University of Bern. “On the contrary: there are a thousand times more scientific facts that show that there is no demonstrable effect.”

Water doesn’t remember, even in homeopathic remedies, Stadler says. He is referring to the extreme dilution of the active ingredients in water, as happens in homeopathy.

The principles of effectiveness, expediency and cost-effectiveness (WZW) should be implemented. Homeopathy cannot provide that. “Imagine if Novartis could not prove this WZW,” says the emeritus professor at the University of Bern. Homeopathy also has special legal treatment with the Swiss Medicines Agency.

While vaccines and medicines must produce clinical studies on their effectiveness, the law stipulates that complementary medicines and herbal medicines can be approved in a simplified manner. This means that documents on safety, harmlessness and effectiveness can be provided based on literature data – without clinical studies.

Lauterbach is right. Stadler wishes the German Minister of Health good luck with his plans, because the homeopathy lobby will attack him strongly – a lot of money is involved.

In Switzerland, compulsory health insurance (OKP) covers the costs of medical services such as acupuncture, drug therapy in traditional Chinese medicine, classical homeopathy and anthroposophical medicine. These five complementary medical specialties were provisionally included in this health insurance in 1999. However, in 2005, this payment obligation was terminated by the federal government and homeopathy had to be paid for again.

But in 2009, voters approved paying for complementary medicine through the ballot box. The federal government and the cantons are therefore obliged by a constitutional article to take complementary medicine into account.

The five disciplines mentioned were therefore provisionally liable for payment from 2012 and definitively from 2017. According to the Health Insurance Regulation (KVV), you must meet certain criteria. Among other things, the scientific evidence that Lauterbach denies homeopathy and anthroposophical treatments must be proven.

If Switzerland wanted to follow the German example, the ball would be in the court of the Federal Office of Public Health (BAG). There is no need for a new initiative or constitutional amendment to remove homeopathy from basic insurance, explains FDP national councilor Andri Silberschmidt, member of the Commission for Social Security and Health (SGK). “In principle, you could eliminate parts of complementary medicine that do not meet the set criteria.” The BAG should enforce this, and this would require leadership from the responsible federal councilor. “I cannot imagine that an SP union councilor would insist on this,” says Silberschmidt.

A private individual whose name we know wants to push this. This has submitted a controversy statement for homeopathy to the BAG. Accordingly, the Federal Office must check whether homeopathy meets the WZW criteria, which are mandatory under the Health Insurance Act to be included in the catalog of benefits of basic insurance. The process is ongoing and the service providers, the umbrella association of insurers and the doctors’ association FMH must submit their declarations to the Federal Commission for General Services and Policy Questions (EKLG).

This committee must submit a proposal to the federal government, which will make the final decision. When asked, the BAG responded: “Given the specific subject, we can confirm that a controversial application has been submitted and that the procedure is ongoing.”

However, homeopathy is not a thorn in Silberschmidt’s side. “But we always believe that the basic catalog needs to be streamlined. It’s not just about complementary medicine. “It’s about adding more and more services,” Silberschmidt says. To save money, you should start with the large pieces. Homeopathy is not such a thing, but the constant dripping erodes the stone.

In principle, alternative insurance models that enable freedom of contract should be further strengthened. That is why everyone should be given the opportunity to free themselves from the rigid corset of health insurance. According to Silberschmidt, this would mean, for example, the freedom to only take out insurance for more serious illnesses. Then everyone would have the choice as to whether complementary medicine is included. Silberschmidt would like to have more personal responsibility in healthcare. “The major costs for more serious diseases must remain compulsorily insured.”

Josef Dittli, member of the Uri FDP Council of States, considers the cost of complementary medicine to be relatively low compared to the total volume of healthcare. Compulsory health insurance statistics show that the cost of complementary medicine is 17 million francs per year. That is not much compared to the total expenditure of 38 billion euros for compulsory health insurance.

Yet complementary medicine is a service that we pay for with our premiums and whose effectiveness has not been proven. “Even if I don’t benefit from it myself because it means nothing to me, I would leave it in. Because there is a constitutional article and many people believe in complementary medicine and the costs are within reasonable limits compared to the total volume,” says Josef Dittli.

Given the pressure on premiums, complementary medicine should not be closed now, but may have to be reintroduced shortly afterwards, due to the will of the people. Just like around the turn of the millennium. What is more important for Dittli is that the benefits and costs of new therapies and commonly sold medicines are consistently examined. The Uri Council of States called for this in a motion in 2019 and its implementation is currently being discussed in parliament.

Zug Green National Councilor Manuela Weichelt strongly disagrees with Lauterbach. The population has clearly approved the constitutional article 'Future with complementary medicine' by 67 percent and with the agreement of all cantons. “The demand for additional medical services remains high. Only through reimbursement through basic insurance does everyone have access to additional medical services.”

Lauterbach's statement is political, but wrong from a scientific point of view. “In Switzerland, scientific research into complementary medical methods, including classical homeopathy and anthroposophical medicine, is part of university research,” says the national councilor, president of the Palliative Care Society. For example, the Institute for Complementary and Integrative Medicine of the University of Bern ideally combines research, education and patient care.

Walter Stüdeli, director of the umbrella association for complementary medicine Dakomed, also echoes this sentiment: “There are now numerous clinical studies that clearly demonstrate the effectiveness of homeopathic preparations. In randomized, double-blind studies, comparisons are made with placebo - the effects are greater than the placebo effect." The public has hardly taken notice of these relatively new scientific studies, says Stüdeli.

Scientist Beda Stadler, who personally witnessed the establishment of a chair for alternative medicine at the University of Bern, does not see it that way. A religion is made of homeopathy and anthroposophical treatment. “If you pay anything for it, that is a misuse of public money.”