Out-Of-Pocket Expenditures on Complementary Health Approaches Associated With Painful Health Conditions in a Nationally Representative Adult Sample

Abstract

National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia.

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

“…26 Also, non-pharmacological treatments that are potentially efficacious for reducing pain’s impact (e.g., mindfulness training) 6 may not be covered by insurance, placing such therapies out of reach for many older Americans. 28 Among older adults with any chronic pain, almost half of individuals in the lowest wealth quartile, and 35% of African Americans, reported that pain impacted their ability to “pay for needs”–suggesting that even in a population largely insured through Medicare, chronic pain presents a financial hardship.…”

Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States

“…7, 8, 10, 11, 14 In 2007, for example, about 14.3 million adults used a complementary health approach for their back pain, while about 5.0 million used these approaches for their neck pain, and 3.1 million for their arthritis. 7 Far fewer individuals used complementary health approaches for other chronic diseases such as depression (1.0 million), hypertension (0.8 million), diabetes (0.7 million) or cancer (0.4 million).…”

“…Based on national survey data, 14 this high use of complementary health approaches for painful conditions translated into $8.5 billion out-of-pocket for these approaches to manage back pain, $3.6 billion to manage neck pain, and $2.3 billion to manage arthritis. Substantially less is spent out-of-pocket on complementary health approaches to treat other chronic health conditions such as depression ($1.1 billion), hypertension ($0.7 billion), diabetes ($0.3 billion), and cancer ($0.2 billion).…”

Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma

“…In 2006, a study found that the most popular CAM providers in Canada were chiropractors (40% of Canadians use during their lifetimes), acupuncturists (17%), naturopaths (9%) and homeopaths (9%) 2. American data suggest that in 2012 Americans spent ∼$30.2 billion on CAM, with adults spending an average of $514 on CAM practitioner visits, supplements and self-care approaches 3. CAM clinics are abundant in each major Canadian metropolitan centre and many of those clinics engage in advertising online.…”