Thursday, September 3, 2009

Americans Spent $34 Billion Out-of-Pocket on CAM in 2007

Adults in the United States spent nearly $34 billion out-of-pocket on visits to complementary and alternative medicine (CAM) practitioners and on purchases of CAM products, classes, and materials in 2007, according to findings released in July from the National Health Interview Survey (NHIS).1

“With so many Americans using and spending money on CAM therapies, it is extremely important to know whether the products and practices they use are safe and effective,” said Josephine Briggs, MD, director of NCCAM in a press release.2 “This underscores the importance of conducting rigorous research and providing evidence-based information on CAM so that healthcare providers and the public can make well-informed decisions.”

The survey found that nearly two-thirds of the total out-of-pocket costs that adults spent on CAM were for self-care purchases ($22 billion), and the majority of out-of-pocket dollars spent on CAM self-care purchases went towards nonvitamin, nonmineral, natural products (which includes herbal preparations).1 Purchases of these products equaled $14.8 billion and accounted for 44% of all out-of-pocket costs for CAM in 2007. Visits to CAM practitioners resulted in an estimated out-of-pocket cost of nearly $12 billion.

The approximately $34 billion spent on CAM visits and purchases equates to 1.5% of total healthcare expenditures in the United States and 11.2% of out-of-pocket healthcare expenditures for 2007. The $14.8 billion amount spent on nonvitamin, nonmineral natural products is approximately 31% of the amount that the public spent out-of-pocket for pharmaceutical drugs in 2007 ($47.6 billion).

Prior to the release of the NHIS survey data from 2007, the latest estimate of CAM out-of-pocket expenditures was from a telephone survey conducted 10 years earlier. The greatest difference between the2 surveys’ results is that the 1997 survey found that most CAM costs were based on visits to CAM practitioners, while the 2007 survey found that most expenditures stem from self-care CAM purchases. These discrepancies may result in part from differences in the surveys’ methodologies. However, the 2007 results are consistent with industry sales data, which also demonstrate a large increase in expenditures for nonvitamin, nonmineral natural products over the past decade.

The NHIS is an annual survey of health and illness-related experiences of Americans conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Information on out-of-pocket costs for CAM from the 2007 NHIS is based on data from interviews of 23,393 American adults.

A previous analysis of results from the 2007 NHIS found that approximately 38% of adults and 12% of children in the United States use CAM, with the most commonly used CAM therapy of both adults and children being nonvitamin, nonmineral natural products, including herbals. Those findings were released in December of 2008, and an article regarding that data was published in the February issue of HerbalEGram.3

© Courtney Cavaliere, American Botanical Council


1.Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. National Health Statistics Reports, Number 18; July 30, 2009.
2. Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine [press release]. Bethesda, MD: National Center for Complementary and Alternative Medicine; July 10, 2009.
3. Cavaliere C. Government survey finds over one-third of American adults use CAM. HerbalEGram, February 2009;6(2). Available at: Accessed August 10, 2009.

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