Homeopathic and herbal medicine: Considerations for formulary evaluation

Homeopathy and herbal medicine are the two subgroups of alternative medicine of-greatest relevance to formulary decision makers. Homeopathy involves therapy with extremely small doses of a pharmacologic agent carefully tailored to the individual patient after detailed history taking. Herbal medicines and their extracts, known as phytomedicinals, are plant-derived products that are promoted for medicinal properties. Unlike homeopathic remedies, many herbal medicines contain active ingredients in sufficient quantity to potentially cause adverse effects. Formulary evaluations of these therapies should be based on efficacy, toxicity, and cost data in comparison with other available treatments. Because these therapies have not been widely studied in controlled trials and are not stringently regulated by the FDA, obtaining such data on these agents poses a formidable challenge to formulary decision makers.