II. EPIDEMIOLOGY

A. Prevalence, Costs, and Patterns of Use of CAM Therapies in the United States

Findings from a 1997 follow-up national survey of complementary and alternative medicine (CAM) prevalence, costs, and patterns of use (19) include the following:

Between 1990 and 1997:

  • The prevalence of CAM use increased by 25 percent from 33.8 percent in 1990 to 42.1 percent in 1997.

  • The prevalence of herbal remedy use increased by 380 percent.

  • The prevalence of high-dose vitamin use increased by 130 percent.

  • The total number of visits to CAM providers increased by 47 percent from 427 million in 1990 to 629 million in 1997.

  • The total visits to CAM providers (629 million) exceeded total visits to all primary care physicians (386 million) in 1997.

  • In 1997, adults made an estimated 33 million office visits to professionals for advice regarding the use of herbs and high-dose vitamins.

  • Estimated expenditures for CAM professional services increased by 45 percent exclusive of inflation and in 1997 were estimated at $21.2 billion dollars.

  • Out-of-pocket expenditures for herbal products and high-dose vitamins in 1997 were estimated at $8 billion.

  • Out-of-pocket expenditures for CAM professional services in 1997 were estimated at $12.2 billion. This exceeded the out-of-pocket expenditures for all U.S. hospitalizations.

  • Total out-of-pocket expenditures relating to CAM therapies were conservatively estimated at $27.0 billion. This is comparable to the projected out-of-pocket expenditures for all U.S. physician services.

  • An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and/or high-dose vitamins. These individuals are therefore at risk for potential adverse drug-herb or drug-supplement interactions.

  • Current use of CAM services is likely to under-represent utilization patterns if insurance coverage for CAM therapies increases in the future.

  • Despite the dramatic increases in the use and expenditures associated with CAM services, the extent to which patients disclose their use of CAM therapies to their physicians remains low. Fewer than 40 percent of CAM therapies used were disclosed to a physician in both 1990 and 1997.



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