Posts Tagged ‘cost effectiveness’

Today, White Paper version 2.0 was published online first at the Website of Journal of Integrative Medicine

Click to access S2095-4964(17)60378-9.pdf

Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management, White Paper 2017

Abstract by Arthur Yin Fan

The title of White Paper is “Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management, White Paper 2017”白皮书的题目是“针灸在解决阿片类药物危机中的作用:针灸作为一线非药物疗法治疗和控制疼痛的证据、花费和医疗服务的可行性”。

There were 6 organizations as the co-publishers-参加发表该白皮书的有6个合作单位:The American Society of Acupuncturists, ASA美国针灸师联合会 、The American Alliance for Professional Acupuncture Safety, AAPAS美国执业针灸安全联盟 ,  The Acupuncture Now Foundation, ANF针灸立刻行动基金会,  The American TCM Association, ATCMA全美中医药学会 ,  The American TCM Society, ATCMS)美国中医针灸学会和全美华裔中医药总会 National Federation of TCM Organizations, NFTCMO 。

White paper  was drafted and edited based on a letter, which original authors were(白皮书起草是在一封信的基础上起步的,信的原文作者是): The Joint Acupuncture Opioid Task Force (Chair: Bonnie M. Abel Bolash, MAc, LAc. Member organizations: The Acupuncture Now Foundation (ANF) ,The American Society of Acupuncturists (ASA) ;组员: Matthew Bauer, LAc ;Bonnie Bolash, LAc ; Lindy Camardella, LAc; Mel Hopper Koppelman, MSc ;John McDonald, PhD, FAACMA ;Lindsay Meade, LAc ;David W Miller, MD, LAc .

The first (revising) author 白皮书修改稿第一作者: Arthur Yin Fan, CMD, PhD, LAc (ATCMA) ;Correspondent author通讯作者: David W Miller, MD, LAc 。Other authors参与白皮书的其他作者: Sarah Faggert, DAc, LAc; Hongjian He, CMD, LAc;Mel Hopper Koppelman, MSc; Yong Ming Li, MD, PhD, LAc ; Amy Matecki, MD, LAc*;David W Miller, MD, LAc; John Pang, MD** , etc . *Division Chief, Dept. of Medicine, Highland Hospital, Alameda Health System; **Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego School of Medicine.


The United States is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public’s opioid dependence. Acupuncture has emerged as a powerful, evidence based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture’s cost-effectiveness could dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding the development of opioid addiction that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options, and acupuncture stands as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost -effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of pain seen commonly in hospitals.

Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military.




  1. Acupuncture is an effective, safe, and cost-effective treatment for numerous types of acute and chronic pain. Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use.


1.1 Effectiveness/Efficacy of acupuncture for different types of pain.


1.2 Safety and feasibility of acupuncture for pain management.


1.3 Cost-effectiveness of acupuncture for pain management.


1.4 Can adjunctive acupuncture treatment reduce the use of Opioid-like medications?


  1. Acupuncture’s analgesic mechanisms have been extensively researched and acupuncture can increase the production and release of endogenous opioids in animals and humans.


  1. Acupuncture is effective for the treatment of chronic pain involving maladaptive neuroplasticity.


  1. Acupuncture is a useful adjunctive therapy in opiate dependency and rehabilitation.


  1. Acupuncture has been recommended as a first line non-pharmacologic therapy by the

FDA, as well as the National Academies of Sciences, Engineering, and Medicine in coping with the opioid crisis. The Joint Commission has also mandated that hospitals provide non-pharmacologic pain treatment modalities.


  1. Among most non-pharmacologic al managements for pain relief now available, acupuncture therapy is the most effective and specific for opioid abuse and overuse.


  1. Acupuncture is widely available from qualified practitioners nationally.


Click to access S2095-4964(17)60378-9.pdf


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The discussion below is only for the patients who have NO acupuncture benefits. If the patients have acupuncture coverage, please read other information in our blogs regarding to the insurance issues.

Different in answers.

When some patients come, they hope we could give them a very low price for acupuncture–if their insurance plan does not cover the acupuncture. They actually have no idea about how much acupuncture price should be.

How much? around $40-50?—acutually, their expectation is, the acupuncture self-pay price is just a little bit higher than or close to the copayment (for example $20-35) in their insurance plan for other medical specialties when they have NO acupuncture coverage in their insurance.

In current market, the average price or cost  for human patients in Washington DC/ Northern Virginia is around $65-110 (do you know how much-if your pets,dog or cat, need to do acupuncture? the Vet-doctors’ fee schedule is–the first session $250, next $125. Much higher than human patients’ payment for acupuncture services). Some acupuncturises may charge $50-60, some may charge more than  $100.  Some also charge initial visit in additional,$40 -100(or more) because the examination/evaluation and paper works.  Some give patients who have no acupuncture coverage in insurance or senior an additional discount.  Some do not. Some offer a free initial visit.

Considering the price, we should think of:

(1) the actual cost in conventional medicine; for example, the treatment for low back pain, how much for the overall price for an operation/surgery? how much for the overall cost of physical therapy? or how much for the overall cost of Chiropractic treatment?

If we consider the cost/effectiveness ratio, acupuncture overall value actually very high.  It means you pay less and get a good result, with less side effect too. That means acupuncture therapy is less expensive one.  But when patient considers their self-payment, they may feel it is high, that is true—if insurance could cover, patients only need to pay the deductible, and copay. i.e. patient think it is high, it is higher than the copayment, but it is much lower than the actual cost in conventional therapies.

(2) the provider’s condition; if we consider the provider’s costs in training, getting experience, the high level / better provider may have better result, or say, patient might see the effectiveness earlier.  So, paying a little bit more to get a better result is not a bad idea.  In a overall view, patient maybe still save money.

(3) see how many therapies, time  or efforts the provider using for patient; if the provider used acupuncture alone 20 mintues for you and charged $80-90, it may be a little bit high;  if use 40-60 minutes, it is valuable;

If the provider uses comprehensive therapies, such acupuncture with electrical therapy, infarared, cupping, tuina, etc., which would be very valuable and patient may see the effectiveness much earlier.

The price should reflect the value– the technology, training and experience level, treatment time, effectiveness, and other costs, such as office running cost, etc.

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