Natural therapies: no clear evidence of health benefits, government review finds

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There is no clear evidence that natural therapies are effective, a government review says, prompting calls for taxpayers and private health insurers to stop paying for them.

A Department of Health review of 17 therapies covered by private insurance released on Monday stated it could not conclude that any worked.

Massage therapy and other natural therapies, may have some benefits, but the evidence was not reliable, the review concluded.
Massage therapy and other natural therapies, may have some benefits, but the evidence was not reliable, the review concluded. Photo: Tamara Dean

While there was “low to moderate quality” evidence that some therapies – for example, massage therapy, yoga and tai chi – may have some health benefits, overall “there was not reliable, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions”, the report, by Chief Medical Officer Chris Baggoley, said.

The federal government spends more than $6 billion on the private health insurance rebate. Parliamentary Budget Office research estimates that the proportion of the rebate spent on natural therapies will cost $67 million in 2017/18, and rise to about $79 million the following year.

Health Minister Sussan Ley has left open the option of cutting rebates for natural health therapies.
Health Minister Sussan Ley has left open the option of cutting rebates for natural health therapies. Photo: Andrew Meares

Public health experts have long called for public subsidies for natural therapies to be scrapped.

The report – commissioned by Labor in 2012 – stressed that the lack of evidence did not mean the therapies did not work, but suggested more research needed to be done, with no systemic reviews into herbalism or iridology.

“Natural therapies emerged in an environment where there was not a premium on rigorous evidence base,” it said.

It was more likely therapies that had “some supporting evidence and scientific plausibility”, such as massage therapy, would be proven effective in future than those that did not, such as homeopathy.

Chief Medical Officer Chris Baggoley.
Chief Medical Officer Chris Baggoley. Photo: Peter Rae

The review excluded research written in languages other than English. It said the key problem was the poor quality of the research that was available. Most natural therapies were difficult to compare with a placebo, and different tools were often used inconsistently to assess therapies.

Health Minister Sussan Ley last month established a review into private health insurance on the back of consumers’ complaints of junk policies that did not meet their expectations. She said the report would be considered as part of the review, due to be completed by the end of this year.

Ms Ley left open the option of cutting rebates for natural health therapies, saying: “I certainly support the theory of government rebates being paid only for health treatments that are evidence based.” 

However, there was nothing to prevent private health insurers from covering natural therapies that did not benefit from a government rebate, she said, and people could also choose whether to use natural therapies.

Leanne Wells, chief executive officer of the Consumers Health Forum, said: “Consumers should not be paying insurance for products or services that are not backed by evidence showing them to be effective.”

A spokesman for shadow health minister Catherine King said: “If the minister wants to pursue an evidence-based approach to health, these figures demonstrate here’s $80 million they could be saving without harming health outcomes, instead of ripping billions out of Medicare.”

Bupa’s managing director, Dwayne Crombie, said the insurer would support a government decision to remove complementary therapy from the private insurance rebate following the review.

“The health system has an affordability problem and Bupa supports efforts to better direct health funding towards treatments where there is a solid evidence base,” he said.

“If the government is looking to look at value for money on the rebate then we would want to see that money reinvested to where it will add greatest value to the health system, such as to help return the rebate on hospital policies to 30 per cent.”