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1Traditional Medicine Research  2020, Vol. 5 Issue (3): 125-135    DOI: 10.12032/TMR20190718125
Special Issue on Infectious Diseases and Public Health     
Complementary and alternative medicine in European countries - legislative framework
Jovana Milenkovic1,*(), Sergey Bolevich2, Gvozden Rosic3
1Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
2Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
3Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia.
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Highlights

The present article reviews the available data regarding the use of the complementary and alternative medicine and the legislation behind it in European countries.

Traditionality

Complementary and alternative medicine has been used for centuries. Since ancient times to date, these methods have been improved in line with the progress of Western medicine. Today, these methods have been applied in many countries around the world.

Abstract

Complementary and alternative medicine (CAM) is a set of different diagnostic and therapeutic procedures, as well as the use of natural products for the treatment of patients, derived from previously known traditional methods and enriched with modern scientific knowledge. The present article reviews the available data regarding the use of CAM and the legislation behind it in European countries. The use of CAM is recorded in Europe as a whole and varies between 10-70% of the population of individual European countries. At least 300,000 registered CAM providers have been identified in the European Union (EU), of which slightly more than half includes non-medical practitioners. The most practiced discipline is acupuncture, followed by homeopathy. CAM regulation and legislation in Europe is not precisely defined and is constantly striving to find a common approach. Since legal frameworks for CAM are not defined, each European country has its own regulations and legislation. In order to define universal legislation for CAM, the EU created the CAMbrella project, a project of the EU designed to find a unique system that would include the treatment of CAM in Europe. According to the data from CAMbrella, from 39 countries in the EU, 17 have general CAM legislations. The status of CAM in Europe is characterized by enormous heterogeneity in all aspects, including terminology, methods, prevalence and ultimately, legal status, regulations and legislation.



Key wordsComplementary and alternative medicine      European countries      Methods of therapy      Legal status      Regulation      Legislation     
Published: 13 April 2020
Corresponding Authors: Jovana Milenkovic   
E-mail: jovannakg94@gmail.com
Cite this article:

Jovana Milenkovic, Sergey Bolevich, Gvozden Rosic. Complementary and alternative medicine in European countries - legislative framework. 1Traditional Medicine Research, 2020, 5(3): 125-135. doi: 10.12032/TMR20190718125

URL:

https://www.tmrjournals.com/tmr/EN/10.12032/TMR20190718125

Country Prevalence rate (%)
United Kingdom 6-71
Germany 4.6-62
Turkey 48-86
Switzerland 5-57
Sweden 5-64
Norway 9-53
Denmark 45-59
Italy 16-84
Israel 5-43
Finland 11-43
Spain 5-47
France 21
Ireland 15
Netherlands 17.2
Poland 14.4
Portugal 43.7
Slovenia 6.6
Table 1 Percentage of CAM usage in different European countries
Country Who is implementing CAM? Insurance Additional education
Austria There are no legal regulations that confirm that use is allowed, but allopathic doctors are allowed to use it. The Health Insurance Fund does not cover services. Some private companies cover CAM. Upgrading 3-4 years
Belgium There is a specific law, CAM is administered only by doctors licensed for this practice. It is not covered by the health insurance fund. Private companies partially compensate for acupuncture and chiropractic. There is an education in the form of training and courses.
Denmark Non-allopathic doctors are not recognized as official providers of health care. The exception is chiropractors. The insurance fund covers partial costs (1/3). ?
Finland Only allopathic doctors and registered chiropractors, naprapathy and osteopaths can practice CAM. Covered by the fund if administered by allopathic doctors. There is no private insurance. Upgrading 3-4 years
France Allopathic doctors provide CAM, while they are not allopathic criminally prosecuted. Chiropractic is legal in France. There is only CAM provided by allopathic doctors. There is education in the form of training and courses.
Germany All licensed doctors can implement CAM practice. It covers some forms of CAM practice. There is also private insurance. There is education in the form of training and courses.
Hungary There is a specific law. Not allopathic doctors are allowed to use CAM if they pass the exam. ? There is education in the form of training and courses.
Ireland Only allopathic doctors can do CAM. It is covered when CAM services are provided by allopathic doctors. Courses and trainings do not exist.
Italy Only registered allopathic doctors can administer CAM. Every Italian region is regulated differently. There is additional education in the form of courses but not legally recognized.
Latvia Local laws regulate CAM. Allopathic doctors may apply it. CAM is not covered by compulsory health insurance. ?
Liechtenstein No specific law. CAM practice in allopathic doctors is not regulated. It is not covered by compulsory health insurance. Training in foreign countries
Luxembourg Only allopathic doctors can do CAM. Only homeopathy is covered by insurance, other disciplines are not covered. There is no officially recognized education.
Malta Only allopathic doctors can do CAM, while they are not allopathic. There is a partial coverage of CAM costs. ?
Netherlands In addition to allopathic doctors, they can also be practiced by qualified practitioners. NO YES
Table 2 Who can use CAM?
Country Acupuncture Chiropractic Homeopathy
1 2 3 4 1 2 3 4 1 2 3 4
Albania + + +
Austria + + +
Belgium + + +
BiH + + +
Bulgaria + + +
Croatia + + +
Cyprus + + +
Czech Republic + + +
Denmark + + +
Estonia + + +
Finland + + +
France + + +
Germany + + +
Greece + + +
Hungary + + +
Iceland + + +
Ireland + + +
Israel + + +
Italy + + +
Latvia + + +
Liechteistein + + +
Lithuania + + +
Luxemburg + + +
Macedonia + + +
Malta + + +
Montenegro + + +
Netherlands + + +
Norway + + +
Poland + + +
Portugal + + +
Romania + + +
Serbia + + +
Slovakia + + +
Slovenia + + +
Spain + + +
Sweeden + + +
Switzerland + + +
Turkey + + +
UK + + +
Table 3 The status of acupuncture, homeopathy and chiropractic in different European countries.
With CAM law With general CAM legislation in health laws Without general CAM legislation
Belgium Switzerland Austria
Denmark Malta Croatia
Germany Bulgaria Cyprus
Portugal Macedonia Czech Republic
Iceland Albania Estonia
Liechtenstein Bosnia & Herzegovina Finland
Norway France
Hungary Greece
Slovenia Ireland
Romania Israel
Serbia Italy
Turkey (since 2015) Latvia
Lithuania
Luxemburg
Montenegro
Netherlands
Poland
Slovakia
Spain
Sweden
UK
Table 4 CAM legislation in different countries
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