ABSTRACT
Aim: To examine the conditions for good medical science and to compare cost-benefit and cost-effectiveness of all types of evidences-based medicine, both pharmaceuticals and non-drug complementary and alternative medicine (CAM) for all clinical conditions.
Method: Calculating therapeutic value (TV = Total number needed to harm (NNHtotal)/Number needed to treat (NNT)) and cost per cured patient (year 1–50) for 10 different types of evidence-based medicine. Cost is presented as EURO (€) per cured patient, EURO per quality-adjusted life year (QALY), EURO per health-adjusted life year (HALY), and number of harmed patients per cured patient. The cost of one year of treatment was set to €2000 and the difference between healthy to 20% (quality of life (QOL), self-rated health).
Results: We found the most effective CAM-types (mind–body medicine, holistic medicine, Shamanism) to be 100 times as cost-effective and 10,000 times less harmful compared to pharmaceuticals. The 50 years’ estimated cost for one patient cured was for drugs €1,000,000; physical therapy €100,000; psychotherapy €100,000; mind — body medicine €50,000; holistic mind–body medicine €20,000; and one-session shamanistic healing with hallucinogenic drugs €2000. CAM is more efficient than drugs and has no side effects and adverse events, whereas treatment with drugs always has adverse effects and events.
Interpretation: To be useful, medicine must have significant therapeutic value (good benefit-to-harm ratio: TV ≥ 1) and documented longterm effect and safety. Holistic mind–body medicine seems to be the safest and most effective of all types of medicine for almost all clinical conditions. The shift from drugs to non-drug CAM would improve health and quality of life radically in society and reduce harm to patients and the cost of healthcare to a small fraction. Strict laws should be introduced immediately in all countries to stop the pharmaceutical industry from promoting drugs without therapeutic value, and from repressing CAM.
