The Australian government review of natural therapies for private health insurance rebates: What does it say and what does it mean?

The review of the Australian Government Rebate on Private Health Insurance for Natural Therapies was set up to examine the evidence of clinical efficacy, cost effectiveness, safety and quality of natural therapies in scope of the Review. The terms of reference of the Review are that this examination will inform the decision on which of the Review's in scope natural therapies should continue to receive the government rebate for private health insurance. However, the practical relevance of the review has been negatively affected by the dearth of ‘whole practice’ evidence in natural therapies, even in instances where there is significant evidence for individual elements of those therapies. This has resulted in evidence being inconclusive in situations where there is broad evidence for the intervention of therapies but not practitioners (e.g. herbal medicine and herbalists), or where sufficient evidence may exist but the evidence refers to international practice rather than Australian (e.g. naturopathy). Some medicines based on traditions outside the English-speaking world (e.g. Shiatsu) were disadvantaged by the paucity of research in the English language. In many instances there was no evidence of positive outcomes for some therapies, based not on negative trials, but the fact that no research articles had been published at all. This article examines in detail the scope and results of the Review and discusses what it may mean for integrative medicine in Australia.