D3.1b - Report highlighting the correct methodology research, carried out by TCM and Western Medicine experts (M24)

As with all health technologies, acupuncture needs to be shown to be cost-effective as well as effective in order to secure funding from public health services. If the health gain from acupuncture is not large enough relative to the cost then overall health outcome would be improved by using scarce health service resources to provide other health care interventions.
Economic evaluation assesses cost-effectiveness. Among other things, the results of an economic evaluation are crucially dependent on the comparator intervention and the context. Just because acupuncture has been found to be cost-effective compared with one intervention, does not mean that it is cost-effective compared with every alternative intervention. Likewise, just because it is cost-effective in one health system it does not mean it will be in another, especially one with a smaller budget.
Interventions that cost less than £20,000-£30,000 (€21,000-€32,000) per quality-adjusted life-year gained are considered to be cost-effective by the National Institute of Health and Care Excellence (NICE) for the National Health Service (NHS) in England. Compared with this threshold, acupuncture has been shown to be cost-effective compared to ‘usual care’ for a number of chronic conditions including dysmenorrhoea, migraine & chronic headache, low back pain, neck pain and osteoarthritis. For all of these conditions, acupuncture appears to offer a modest improvement in patients’ overall quality of life for a modest increase in cost.
The translation of cost-effectiveness in to clinical practice recommendations has not always been straightforward because NICE’s committees often require that there is evidence that acupuncture has improved effectiveness over sham. This is not always proven even in circumstances where acupuncture has been shown to be cost-effective compared with usual care.
The evidence for the cost-effectiveness of acupuncture is limited. Studies for different populations and different comparators in different countries are needed. However, the cost-effectiveness of acupuncture has been investigated more thoroughly than that of many health interventions.

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