Economic evaluation of Sinfrontal in the treatment of acute maxillary sinusitis in adults.

Sinfrontal, a complex homeopathic medication, is popular in Germany for the treatment of ear, nose and throat and respiratory tract infections. Unlike many other homeopathic or herbal medications, the efficacy and safety of Sinfrontal has been demonstrated in a number of clinical studies of patients with sinusitis. To assess the cost effectiveness of Sinfrontal versus placebo in the treatment of adults with acute maxillary sinusitis (AMS) in Germany. A secondary objective was to assess the cost effectiveness of Sinfrontal versus standard treatment with antibacterials. Sinfrontal was compared with placebo in a cost-utility analysis based on data from a randomized controlled clinical trial over 3 weeks (Sinfrontal group: n = 57; placebo group: n = 56). Trial data were analysed from a societal perspective; resource use was valued with German unit costs for 2005. In a secondary analysis, the longer-term cost utility of Sinfrontal versus placebo was estimated over a total of 11 weeks based on an 8-week post-treatment observational phase. In addition, the cost effectiveness of Sinfrontal versus antibacterials was determined based on an indirect comparison of placebo-controlled trials. Sinfrontal led to incremental savings of euro 275 (95% CI 433, 103) per patient compared with placebo over 22 days, essentially due to the markedly reduced absenteeism from work (7.83 vs 12.9 workdays). Incremental utility amounted to 0.0087 QALYs (95% CI 0.0052, 0.0123), or 3.2 quality-adjusted life-days (QALDs). Bootstrapping showed that these findings were significant, with Sinfrontal being dominant in 99.9% of simulations. The results were robust to a number of sensitivity analyses. In the secondary analysis, Sinfrontal led to incremental cost savings of euro 511 and utility gains of 0.015 QALYs or 5.4 QALDs compared with placebo. Compared with antibacterials, Sinfrontal had a significantly higher cure rate (11% vs 59%; p < 0.001) at similar or lower costs. The results of this economic evaluation indicate that Sinfrontal may be a cost-effective treatment for AMS in adults.

Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children.

OBJECTIVES: A pharmacoeconomic study to compare, in terms of: medical effectiveness, quality of life and costs two treatment strategies ('homeopathic strategy' vs 'antibiotic strategy') used in routine medical practice by allopathic and homeopathic GPs in the treatment of recurrent acute rhinopharyngitis in 18-month to 4-year-old children. METHODS: Statistical analysis of data obtained from a population of 499 patients included in a previous 6-month prospective, pragmatic study. The patients were regrouped according to type of drug prescribed. Medical effectiveness was assessed in terms of (i) episodes of acute rhinopharyngitis, (ii) complications, (iii) adverse effects. Quality of life was assessed using the Par-Ent-Qol scale. Direct medical costs (medical consultations, drug prescriptions, prescriptions for further tests) and indirect medical costs (sick-leave) were evaluated from three viewpoints (society, patient, Social Security) using public prices and French Social Security tariffs. RESULTS: The 'homeopathic strategy' yielded significantly better results than the 'antibiotic strategy' in terms of medical effectiveness (number of episodes of rhinopharyngitis: 2.71 vs 3.97, P<0.001; number of complications: 1.25 vs 1.95, P<0.001), and quality of life (global score: 21.38 vs 30.43, P<0.001), with lower direct medical costs covered by Social Security (88 Euros vs 99 Euros, P<0.05) and significantly less sick-leave (9.5% of parents vs 31.6% of parents, P<0.001). CONCLUSIONS: Homeopathy may be a cost-effective alternative to antibiotics in the treatment of recurrent infantile rhinopharyngitis.

Comparative efficacy of homeopathic and allopathic systems of medicine in the management of clinical mastitis of Indian dairy cows.

Mastitis is the major problem of dairy animals despite a number of preventive and therapeutic approaches. Treatment is costly and out of reach of farmers of developing countries like India. The treatment cost of bovine mastitis with conventional treatment has been calculated. Good results have been claimed with homeopathic treatment however, treatment costs are not available. This article reports the treatment economics of homeopathic drugs conventional drugs for the management of bovine mastitis. Ninety-six mastitic quarters (non-fibrosed 67 and fibrosed 29) were treated with a homeopathic combination medicine. Another 96 quarters with acute mastitis (non-fibrosed) treated with different antibiotics were included in the study. The animals were selected from dairy farm of the Indian Veterinary Research Institute and from private dairy farms. The overall effectiveness of homeopathic combination medicine in the treatment of acute non-fibrosed mastitis was 86.6% with a mean recovery period of 7.7 days (range 3-28), and total cost of therapy as Indian Rupees 21.4 (0.39 Euros, US$ 0.47). The corresponding cure rate for the antibiotic group was 59.2% with a mean recovery period of 4.5 days (range 2-15) and an average treatment cost of Rs.149.20 (2.69 Euros, US$ 3.28). We conclude that the combination of Phytolacca, Calcarea fluorica., Silica, Belladonna, Bryonia, Arnica, Conium and Ipecacuanha (Healwell VT-6) was effective and economical in the management of mastitis in lactating dairy cows.