Americans spend about $34 billion annually on alternative medicine, according to the first national estimate of such out-of-pocket spending in more than a decade.
Chiropractors, acupuncturists and herbal remedies are commanding more consumer dollars as people seek high-touch care in a high-tech society, the report released Thursday by the government shows.
"We are talking about a very wide range of health practices that range from promising and sensible to potentially harmful," said Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, the federal agency that leads research in this field.
More research into which therapies work is critically needed, because the spending on them is "substantial," she said.
Some consumer advocates say people are wasting money on some products that rigorous studies already have shown don't work.
"Even in these recessionary times, a great deal of money is being spent on some forms of complementary and alternative medicine whose efficacy is questionable," said Bruce Silverglade, director of legal affairs for the Center for Science in the Public Interest, a consumer advocacy group.
Another advocate, Dr. Sidney Wolfe, who leads Public Citizen's health research, has long criticized the government for what he considers lax regulation of prescription drugs and mainstream medicine. Yet, he also sees problems with the widespread use of supplements.
"People think they are cleared" by the Food and Drug Administration, he said, when in fact they do not need proof of safety or effectiveness to go on the market.
The report is based on a 2007 survey by the U.S. Centers for Disease Control and Prevention of more than 23,000 adults nationwide. An earlier report from this survey, released in December, found that more than one-third of adults use alternative medicine.
That includes a wide range of services from meditation and yoga to dietary supplements, such as echinacea and ginseng. Vitamins and minerals are not included in this report but will be addressed in a future one.
Pain a main driver
Pain was the main reason people tried massage, chiropractic care and other alternative therapies. Among supplement users, most popular were glucosamine for joint pain and fish oil to cut the risk of heart disease.
The new survey results focus on how often Americans use these things, and how much they pay for them.
Alternative medicine now accounts for more than 11 percent of out-of-pocket spending on health care in the United States, the researchers said.
About 44 cents out of every dollar spent on alternative medicine was for products like fish oil, glucosamine and echinacea. Spending on these products was nearly $15 billion, or about a third of what Americans spend out-of-pocket for prescription drugs.
"I personally am pretty conservative about supplement use," Briggs said. She believes that research her center has sponsored has had an effect on consumer use, with sales of some herbal supplements falling as research has shown their ineffectiveness.
The survey shows about 35 cents of each alternative therapy dollar was for visits to acupuncturists, chiropractors, massage therapists and other practitioners. That totals nearly $12 billion, or about one-quarter of what Americans spend on visits to mainstream physicians.
"Some of the useful things chiropractors are doing amounts to physical therapy," Wolfe said. "Medicine is beginning to realize how important physical therapy is."
Rising cost of natural cures
The last government estimate out-of-pocket spending on alternative medicine came from a 1997 survey. That research estimated $27 billion was being spent.
The new report concludes that 38 million adults visited alternative medicine practitioners in 2007. They paid less than $50 per visit on average, but many paid $75 or more for services such as acupuncture, homeopathy and hypnosis therapy.
The average annual spending per person to see practitioners was about $122, and the average spending on products was $177.
A whopping $3 billion was spent on homeopathy — highly diluted drugs made from natural ingredients. It is based on a theory unverified by mainstream science: that substances that create certain symptoms in healthy people are effective in treating the disease that causes the same symptoms.