[Herbal drugs: luxury or basic therapy in federal insurance practice?]

Over the past 6 years SHI-accredited prescriptions for herbal medicinal products have decreased in Germany by around 40% (Social Health Insurance). However, this has not reduced overall drug expenditure for the statutory health insurers; in fact costs have increased more sharply than before. This development was recently explained by "Modernisation of Pharmacotherapy" which picked out 5 groups as examples. The present paper examines one of these examples, i.e. modern antidepressant therapy, and compares it with the results of recent studies and meta-analyses of herbal and synthetic preparations. Above all, the comparison for this indication revealed that the medication itself, independent of which group it belongs to, contributes merely one third of the treatment results whereas the remaining two thirds are contributed by therapists and their surroundings. Experienced physicians achieve virtually the same treatment results with suitable St. John's wort preparations as they do with modern synthetic antidepressants. Hence, medically supervised therapy with herbal medicinal products for suitable indications could avoid billions in development and treatment costs for supposedly innovative drugs. These savings would then benefit broader basic therapy.