industry news and legislative updates

Complementary & alternative medicine use Steady five-year prevalence points to need for more rigorous evaluation

This story adapted from a press release published by the public affairs department at Harvard Medical School http://hms.harvard.edu/hms/home.asp

Researchers from Harvard Medical School found more than one in three U.S. adults (36.5 and 35.0 percent, respectively) used at least one form of CAM when they compared complementary and alternative medicine (“CAM”) use by adults in 1997 and 2002.

The continued widespread use of individual and multiple CAM therapies underscores the need to rigorously evaluate the safety, efficacy, and cost-effectiveness of these approaches, according to the study's lead author Hilary Tindle, Harvard Medical School (“HMS”) research fellow, and co-author David Eisenberg, director of the Division for Research and Education in Complementary and Integrative Medical Therapies and the Harvard Osher Institute at HMS.

The study results appear in the January/February issue of the medical journal Alternative Therapies in Health and Medicine.

The study compared results of the National Health Interview Survey in 2002 and a survey conducted by researchers at HMS (Eisenberg et al.) in 1997. The two surveys were similar but not identical. Prior to this study, there had been no head-to-head comparison using a common definition of CAM.

"Our research over the past 14 years has shown a consistent level of usage by adult Americans," said Dr. Eisenberg. "While there have been a few notable changes in which CAM therapies people are using, the overall number of adults employing some type of CAM has remained remarkably consistent since we began our surveys in 1990. This says to us that these therapies are part of the fabric of modern day health care, and that we need to do more research on their safety and effectiveness - just as we would with any other therapeutic options," concludes Eisenberg.

Over the five-year period between the two most recent surveys, the total number of Americans using any CAM therapy remained fairly stable at 72 million. However, there were changes in the choice of CAM therapies used.

The largest change was a 50 percent jump in the use of herbal supplements, growing over the five years from 12.1 percent of adults reporting usage in 1997 to 18.6 percent -- or 38 million adults -- in 2002. The practice of yoga increased 40 percent over the same period, growing from 3.7 percent in 1997 to 5.1 percent-- over 10 million adults-- in 2002.

Use of CAM therapies such as acupuncture, biofeedback, energy healing, and hypnosis remained essentially unchanged between 1997 and 2002, while the use of homeopathy, high-dose vitamins, chiropractic, and massage therapy declined slightly. Since many CAM therapies are paid out-of-pocket by consumers, the authors suggest that some of these declines may be due, at least in part, to a downturn in the U.S. economy from 1997 to 2002.

The ways in which several CAM therapies are used also appear to have changed. For example, only 5 percent of people who used herbs saw a practitioner of herbal medicine in 2002, compared to 15 percent in 1997. "Such changes are important considering that other research has shown that 60 to 70 percent of patients who use CAM therapies do not disclose it to their physician," says lead author Dr. Tindle. "This is especially critical as more becomes known about the adverse effects associated with individual dietary supplements as well as their interactions with prescription drugs".

Despite variability seen in previously published reports about overall CAM use, the authors conclude the use of CAM by one third of U.S. adults from 1997 to 2002 appears to have been steady, reconfirming results from the first national survey in 1990.

This work was made possible in part by grants from the National Center for Complementary and Alternative Medicine and by private foundation grants: Horton Family Fund; Seattle Foundation; John E. Fetzer Institute; American Society of Actuaries; Friends of Beth Israel Deaconess Medical Center; Kenneth J. Germeshausen Foundation; and the J.E. and Z.B. Butler Foundation.

CANCER STATISTICS AVAILABLE FROM the FDA

A federal report using the most up to date statistics available says that prostate cancer is the leading cancer diagnosed in American men and breast cancer is the most common form of cancer diagnosed in U.S. women. The leading cause of cancer death for both men and women is lung cancer.

The report, titled United States Cancer Statistics: 2001 Incidence and Mortality, includes quality-assured incidence data from 43 states, six metropolitan areas, and the District of Columbia, covering 92 percent of the U.S. population. The report supplies essential state, population, racial, ethnic, and gender information to support tailored cancer prevention and control programs nationwide.

The comprehensive report on state-specific cancer rates includes, for the first time, information on incidence and death rates, as well as data for Hispanics and a new section on mesothelioma and Kaposi's sarcoma.

United States Cancer Statistics: 2001 Incidence and Mortality marks the third time the Centers for Disease Control and Prevention and the National Cancer Institute, in collaboration with the North American Association of Central Cancer Registries, have combined data to produce federal cancer statistics. The annual report provides a basis for individual states and researchers to describe the variability in cancer incidence and death rates across different populations and to focus on certain populations for evidence-based cancer-control programs. Future United States Cancer Statistics reports will include data for American Indians/Alaska Natives. The full report is available at www.cdc.gov/cancer/ and www.seer.cancer.gov/statistics/.

New five-year plan for NIH alternative medicine center

This story adapted from a February 7, 2005 - press release published by the National Institute of Health

The National Center for Complementary and Alternative Medicine (“NCCAM”) announces the release of its new 5-year strategic plan, Expanding Horizons of Health Care: Strategic Plan 2005-2009. The plan, available online at http://nccam.nih.gov/about/plans/2005/, presents a series of goals and objectives to guide NCCAM in prioritizing its investments in complementary and alternative medicine (“CAM”) research, training, and outreach.

The plan was developed by reviewing NCCAM accomplishments, summarizing the lessons learned, and noting the challenges the Center faces. The document is based on extensive public input, the advice of NCCAM staff, and the recommendations of a distinguished group of outside experts. During the year-long process of development, hundreds of people testified at regional meetings, provided comments in letters and e-mails, and responded to the draft plan on the NCCAM Web site.

The plan addresses four key areas: investing in research, training CAM investigators, expanding outreach, advancing the organization, and also sets ambitious goals for the coming years. Goals for research investment are laid out as well as goals for building research resources; mind-body medicine; biologically based practices; manipulative and body-based practices; energy medicine; whole medical systems; international health research; health services research; and ethical, legal, and social implications of CAM research and integrated medicine.

The National Center for Complementary and Alternative Medicine (NCCAM) is dedicated to exploring complementary and alternative medical (CAM) practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCAM’s Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at http://www.nccam.nih.gov

The Institute for Alternative Futures Takes Another Look at Chiropractic

In 1998 the Institute for Alternative Futures (“IAF”) issued a major report on the future of chiropractic care in the US. IAF has revisited its research to develop its report: The Future of Chiropractic Revisited: 2005 to 2015. As of January 31st, the report will be available on IAF's website: http://www.altfutures.com.