Despite a growing chorus of expert voices questioning homeopathy, some doctors suggest it is being unfairly targeted.
Debate over homeopathy has been triggered after the publication of an opinion piece attacking private health insurance companies for covering homeopathy in the current issue of Australasian Science.
"There is no evidence for homeopathy yet medical insurance companies - subsidised by the government - are extending their cover due to client demand," writes Dr Ken Harvey, an adjunct senior lecturer in La Trobe University's School of Public Health.
"While some homeopathic studies of low methodological quality have found benefits, analyses of higher quality trials generally show that homeopathy treatments are no more effective than a placebo."
Harvey points to World Health Organization recommendations against using homeopathy for treatment of serious disease, and the conclusions of a UK House of Commons Science and Technology Committee that the UK health service should cease funding the treatment.
While there is no direct government funding of homeopathy in Australia, Harvey is concerned about its support from private health insurance companies.
"I am concerned that private health insurance premiums are higher than they need to be because the insurers involved fund alternative therapies that lack an evidence base, such as homeopathy, reflexology and iridology," he says.
But some doctors suggest homeopathy is being unfairly targeted.
"It smacks of a crusade to me," says Professor Kerryn Phelps, president of the Australasian Integrative Medicine Association (AIMA), which promotes "the integration of safe, evidence-based complementary medicines and therapies with current mainstream medical practice".
She does not believe homeopathy is having the kind of impact on private health premiums Harvey fears, and says there are "bigger fish to fry" when it comes to fixing the healthcare system.
Phelps says homeopathy can be easily criticised because it has a relatively small evidence base.
But, she suggests orthodox treatments are not subject to the same level of scrutiny.
"The Journal of the American Medical Association earlier this year produced a meta-analysis of SSRI anti-depressants in mild to moderate depression and found them no better than placebo," says Phelps, who is Conjoint Professor in the School of Public Health and Community Medicine at the University of New South Wales and a former president of the Australian Medical Association.
"If you are going to exclude treatments that don't have an evidence base then we have to start looking at pharmaceuticals that don't have an evidence base, surgical therapies that don't have an evidence base."
Matter of evidence
Dr Vicki Kotsirilos, who originally founded AIMA, says she is sympathetic to Harvey's concerns but rejects some of his conclusions.
"To say that there is no evidence for homeopathy is actually incorrect and unfortunately a lot of people make those statements," says the Melbourne-based GP, who points to evidence collected by the British Homeopathic Association.
"There have been systematic reviews that have shown that overall homeopathy is not anymore of benefit to placebo or of marginal benefit. But there have been some Cochrane Collaboration reviews that there is a little bit of research available for some therapies."
She says some of the major studies quoted don't properly take into account how homeopathy is used.
"When you prescribe homeopathy, it's often individualised and you won't use the same homeopathic remedy for one person with a particular disease to another person with the same disease," says Kotsirilos.
She says homeopathy, and other complementary therapies, are particularly popular among patients who have suffered side-effects from medication, or where surgery is contraindicated.
"Out of all the complementary medicines it is the least understood, with the least amount of research," says Kotsirilos, who calls for more funding for research.
"We need more research to be able to identify which patients might benefit from homeopathy and in what conditions, bearing in mind that there are people out there who choose to use this and we have to respect their choices."