NCCAM fails at most basic mission

Once again, proof has been provided that when it comes to research at the National Institutes of Health (NIH)…unfortunately, it seems some things never change.

In this case, a new report published in the British Medical Journal appears to deliver good news for complementary/alternative medicine (CAM). And, indeed, the report found that complementary and integrative care is more cost effective in over two dozen studies.

However, to those of us “on the inside,” it shows how little the NIH actually does to move this safe, effective, and “affordable” healthcare “forward”…

In 1998 I was nominated by Senator Tom Harkin to serve as FDA Commissioner. This gave me the opportunity to engage in serious discussions about a number of topics, including our mutual interest in complementary/alternative and natural medicine.  

We felt it was time for the NIH to begin to step it up a notch. To move beyond the endless, redundant research they’d been doing on CAM.

Up until 1998, the NIH research had been circling on proving the safety and effectiveness of CAM. Which is all well and good, but how many decades and tax-payer dollars should we waste on proving what we already know?

After all, most CAM therapies have been known to be safe and effective thanks to hundreds and even thousands of years of use around the world. Many are even accepted by medical regulators in Germany, for example, based on “historical use.” So why waste more taxpayer dollars and time in reinventing the wheel?

We wanted NIH to start studying how to integrate these therapies into medical practice. This has become known as “complementary and integrative medicine”—a concept with which I’m partly credited, but with mixed feelings (stories for another day).

Sen. Harkin and I agreed it was time to invest in more practical research on CAM. To learn how to train health professionals and to start making CAM more readily available. With the goal being to help our expensive, ailing, and failing healthcare system with more cost-effective measures. 

I didn’t trust the NIH to carry out such a mandate (as I warned Sen. Harkin). So I personally moved on to working with other more practical agencies such as the U.S. Health Resources and Services Administration and their Bureau of Primary Care and Bureau of Health Professions. While Sen. Harkin and his congressional colleagues created the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM).

They charged NCCAM to engage in research that would help provide cost and effectiveness data on real-world outcomes of CAM therapies and how CAM could impact health services. Essentially, to find data that would help us understand the cost and effectiveness of the integration of CAM into the U.S. healthcare system.

And now, nearly 15 years later…this new report affirms my instincts, despite the good efforts of Sen. Harkin. The report found just 28 high-quality studies on the cost-effectiveness of CAM. And that was over a 10-year period (2001-2010), including international study results.

Which begs the question—what has NCCAM been doing for the past 14 years?!

NCCAM has clearly turned its back on Sen. Harkin’s original mandate. Not to mention the justification for their massive increase in funding. As my old friend, journalist John Weeks, has reported in, less than 1 percent of NCCAM grants funded appropriate studies and just a .025 percent examined costs. And that’s according to the NCCAM’s own internal data during 2002 to 2006.

And while NCCAM claims their plan for the future has a “real world” direction, it appears any new investigation of cost-effectiveness remains negligible. 

On the positive side, studies undertaken by other researchers (like the BMJ article cited above) have again largely shown what many of us have already known.

Many CAM therapies are more cost-effective than mainstream medical therapies. Not to mention safer, less invasive, less unpleasant, generally more “healthful,” and an overall better experience for patients.

Unfortunately, the NIH won’t stop chasing its tail long enough to actually help get these therapies into your hands more efficiently and effectively.

Herman PM, Poindexter BL, Witt CM, et al. “Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations.” BMJ Open 2012;2:e001046.