The 1994 Dietary Supplement and Health Education Act (DSHEA) has been a key factor in influencing the use of Complementary and Integrative Health (CIH) approaches. Along with natural products or dietary supplements, there has been an increase in the use of mind-body approaches such as yoga, osteopathic and chiropractic manipulations, etc., with estimates of approximately 36% of the US population having used at least one such approach in prior two years and 33.2% of the US population using it for pain management as per the National Health Information Survey (NHIS). From patient perspective, there has been a consistent increase over the last two decades in the use of CIH approaches for various disease indications despite this being out-of-pocket expenditure. This is because it is at odds with the Commercial Payers’ perspective that focuses on elements like evidence-based improvements in health outcomes, specific clinical endpoints and lower cost (decreased hospitalizations, medication use, emergency room visits).. CIH approaches that include conventional treatment along with complementary practices, may augment patient health experience positively, reducing health disparities and provide better health outcome at potentially lower cost, satisfying both the patient and commercial payer’s perspective. For conventional healthcare systems to adopt truly integrated CIH approach, the major drivers will have to include clinical and cost-effectiveness parameters. Outcomes research assessing impact on quality of life, can be pivotal in bringing this approach to the commercial payer’s domain. We also propose an organized database accessible to the relevant stakeholders, mapping the use of CIH approaches by patients in the real world. Such information linking specific approaches to specific therapeutic areas can lead to better understanding and help in devising strategies to selectively bring CIH approaches to the mainstream.

1. Kinser PA, et.al. Evidence based Complementary and Alternative Medicine, Vol 2016, Article ID 2156969
2. https://nccih.nih.gov/health/integrative-health accessed on 18th Jan 2017