The Institute for Economic Review, "an independent, nonprofit research organization that evaluates medical evidence and convenes public deliberative bodies to help stakeholders interpret and apply evidence to improve patient outcomes and control costs," has announced that adequate evidence supports payer coverage of acupuncture to manage chronic low back pain in conjunction with usual care.
The announcement is based on the ICER's Final Evidence Report, which determined acupuncture and other therapies (yoga, cognitive behavioral therapy and mindfulness-based stress reduction) offer benefits without the clear risks associated with conventional medical management (opioids and surgery).
The ICER recruited researchers to study whether acupuncture, among other methods, offered adequate benefits to be regarded as a covered insurance benefit. The Final Evidence Report was prepared for the California Technical Assessment Forum, a core program of the ICER that "provides a public venue in which the evidence on the effectiveness and value of health care services can be discussed with the input of all stakeholders."
Following a public meeting, the CTAF Panel voted on the report, including 14-0 in the affirmative when posed this question: "For individuals with chronic low back pain, is the evidence adequate to demonstrate that acupuncture provides additional net health benefit when added to usual care?"
"Unfortunately, even in the face of an opioid epidemic, many patients are not offered these alternative types of pain management," said ICER Chief Medical Officer David Rind, MD, MSc. "Stakeholders, particularly payers, should work to ensure that patients are able to access a broad range of evidence-based non-drug interventions with at least as much ease as they are able to access pharmacologic treatments."
Structured water (H3O2) can be considered a fourth state of water between liquid and solid. It has the hexagonal structure of ice; however, missing a critical bond, it behaves more like a gel than a solid, but retains some of its crystalline structure.
In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD. It is not uncommon to encounter patients taking these prescriptions for five-plus years.
Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
