What the studies really say

Is homeopathy effective or is it just a placebo? The question has been debated for many years. In France, its de-reimbursement in 2021, after almost 30 years of coverage, marked a turning point, and the meta-analyses published on the subject fuelled the controversy.
So, what do the scientific studies really say?

The Australian NHMRC report: a contested meta-analysis

One of the most cited studies against homeopathy is the Australian meta-analysis published in 2015 by the National Health and Medical Research Council (NHMRC).

What does this meta-analysis say?

  • It concludes that homeopathy is no more effective than a placebo for treating various diseases.
  • This report has influenced policy decisions, including the withdrawal of reimbursement for homeopathic treatments in France in 2021 and the cessation of their funding by the NHS in the UK in 2017.

Why is this study controversial?

Biased study selection process?

  • Of the 1800 studies identified, only 225 were selected, and of these, only 5 were deemed to be of sufficient quality.
  • The selection criteria applied were more stringent than those generally used in studies on conventional treatments, which led some researchers to accuse a selection bias.

A first censored report?

  • In 2012, the NHMRC commissioned an initial analysis, written by an external scientist, which presented more nuanced conclusions on homeopathy.
  • This report was never published, which raised suspicions of lack of transparency and possible manipulation of results.

Accusations of scientific fraud

  • Some homeopathy advocates accuse the NHMRC of deliberately skewing its analysis to discredit homeopathy.
  • In 2019, an independent review highlighted methodological irregularities in the NHMRC study.

Other more nuanced meta-analyses: the example of Klaus Linde (1997)

Prior to the Australian report, other meta-analyses had been conducted, notably the one published in 1997 in The Lancet by Klaus Linde.
Results of this study:

  • 89 randomised clinical trials were examined.
  • Conclusion: homeopathic treatments show an effect superior to placebo.
  • However, the methodological quality of the studies was considered uneven, making it difficult to reach a definitive conclusion.
    Key quote from the study: ‘The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are entirely due to the placebo effect.’

Difference with the NHMRC report: Linde and his team included a larger number of studies and applied less restrictive selection criteria, unlike the NHMRC.

Why is it difficult to test homeopathy with conventional studies?

In modern medicine, the effectiveness of a treatment is generally evaluated by randomised double-blind placebo-controlled clinical trials.
Definition of these evaluation criteria :

  • Placebo: One group receives an inactive treatment to compare the real effects of the medication.
  • Double-blind: Neither the patients nor the prescribers know who is taking the real treatment or the placebo.
  • Randomisation: Random distribution of patients into two groups to avoid bias.
  • Multicentre: Study conducted in several medical centres to limit local influences.

Why are these requirements penalising homeopathy?

Homeopathy is based on individualised treatment

  • Unlike conventional medicines, homeopathy adapts each treatment to the unique profile of the patient.
  • Testing a single homeopathic remedy on a group of patients with the same disease does not reflect the reality of homeopathic practice.

Methodological problems in clinical trials

  • Randomised studies often evaluate a single remedy for a specific condition, which does not correspond to the logic of unicist homeopathy which adapts the treatment to each individual.
  • Some studies have attempted to circumvent this problem by including several remedies tailored to the patients’ symptoms, thus obtaining better results.
  • However, this approach increases the complexity and cost of the studies, making them difficult to implement.

Solid studies exist: the example of Robert Mathie

Despite these methodological difficulties, some rigorous studies have shown positive effects of homeopathy.

Robert Mathie’s meta-analyses (2014-2019):

  • One of the most recognised researchers in the field, Robert Mathie, has carried out several in-depth analyses of clinical trials on homeopathy.
  • By examining high-quality randomised trials, he found significant positive results for certain medical conditions, although the evidence remains heterogeneous.

Conclusion: homeopathy, a subject still under debate

What can we learn from the studies on homeopathy?

  • Some meta-analyses, such as that of the NHMRC, conclude that there is no proven efficacy.
  • Other analyses, such as those of Linde or Mathie, find positive results but call for better designed studies.
  • The methodological limitations of randomised clinical trials make it difficult to evaluate homeopathy, which is based on an individualised and holistic approach to the patient.

In a nutshell, homeopathy is:

  • a gentle and side-effect-free approach.
  • a holistic view of health, taking into account both physical and emotional aspects.
  • positive personal experiences.
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