Paris (AFP)
Homeopathy, which the government has decided to no longer make reimbursement by social security from 2021, with less support from 2020, is the most popular of "alternative medicine" and also one of the most controversial.
Reminder of the principles, uses and criticisms surrounding this medical practice:
- Principles -
Homeopathy was born in the late eighteenth century experiments of the German physician Samuel Hahnemann. This therapeutic method is based on three principles:
- The similarity ("homeo" means "same" in Greek) is to treat with vegetable, mineral or animal substances that cause symptoms similar to the disease.
- The infinitesimal doses: the substances are diluted so that they are no longer toxic. 1% dilutions are repeated several times. Thus the mention "9 CH" on a tube means that 1% dilutions were performed nine times, which is equivalent to dilute one cubic meter of water in the total volume of the world's oceans.
- Individualization: Homeopathy considers the patient as a whole and does not focus on symptoms alone.
- Uses -
More than half of French people (58%) have already used homeopathic products "several times", according to an Ipsos survey conducted in October 2018 on behalf of three homeopathic laboratories.
Currently reimbursed up to 30% (for only part of its products), and only 15% in 2020, before a total reimbursement the following year, homeopathy weighs very little in social security spending: 126.8 million euros out of a total of 19.6 billion drugs reimbursed in 2018, according to the Health Insurance.
However, for the French economy, homeopathy is a significant sector with 3,200 direct jobs and a world leader based in Lyon, Boiron.
Marketing authorizations for homeopathy do not meet the same requirements as for conventional medicines: no need to provide data on the effectiveness of the product. But they must be sufficiently diluted to guarantee their "innocuousness".
Homeopathy is not recognized as a true medical specialty in France. But faculties offer future doctors or health professionals training validated by "university degrees".
According to the National Union of French Homeopathic Doctors (Snmhf), 5,000 homeopathic doctors were practicing in the country in 2016. According to Boiron, 20,000 of the 100,000 generalists regularly prescribe homeopathic granules.
Elsewhere in Europe, the status of homeopathy varies widely: widely practiced and reimbursed in Germany, homeopathy is virtually absent from the NHS, the UK public health system that recommended in 2017 to its doctors to stop prescribing it.
Spanish homeopathy, which is not very widespread and in decline in Spain, has been strongly criticized by Madrid, which set up a plan in November 2018 to fight against "pseudotherapies".
- Reviews -
In France, the positions of doctors against homeopathy have multiplied. The National College of Teaching Generalists (CNGE) called in January 2019 to stop the reimbursement of homeopathy described as "esoteric method". The Academies of Medicine and Pharmacy launched a similar appeal in March.
The Association of Academies of European Sciences (EASAC) pointed out in September 2017 that there is "no evidence, scientifically established and reproducible of the effectiveness of homeopathic products, even if there is sometimes a placebo effect." Homeopathy can even "have a harmful effect by delaying consultation with a doctor," according to EASAC.
More nuanced, the former head of marketing authorizations at the French Drug Agency, Professor Jean-François Bergmann, recognizes this discipline the effectiveness of a placebo "magnified" by the patient's confidence in his homeopathic doctor.
This head of department at the Lariboisière hospital (Paris) "does not grant any pharmacological property to homeopathy" but considers that it would be "not rational not to take into account the irrational in humans" in the collective work "The truth about your medicines".
? 2019 AFP