Etat des lieux de l'homéopathie en Belgique - KCE

92 Homeopathy KCE Reports 154
5.6.3.3 Specificities for homeopathy
Reimbursement for homeopathic products
A first agreement between the sickness funds, restricted the reimbursement of
homeopathy to the partial reimbursement of homeopathic products. The list of
homeopathic products 117 is established after consensus with the only professional union
at that moment, i.e Unio Homeopathica Belgica. To ensure the safety of the products
for the patients, all products have to be diluted with 10000 (D4), they may not be
derived from human or animals’ organs and may only be applied orally. These products
have to be prescribed by a physician (whether or not homeopath) and have to be
delivered by a pharmacist. In the software system of the pharmacist all recognised
homeopathic products are characterised with an asterisk and the pharmacist delivers an
uniform certificate (BVAC-certificate) (BVAC-Bijkomende Verzekering Assurance
Complémentaire). With this certificate the patient can request a partial reimbursement
of homeopathic products, but also for other products such as vaccines, contraceptives
and smoking cessation medication. The partial reimbursement ranges from 20 to 50%
with an average ceiling of 70euros per year (ranging from 62 to 186euros per year). The
Christian sickness fund is the only sickness fund with no ceiling for reimbursement.
Some private insurance companies provide a reimbursement up to 80% for
homeopathic products after ambulatory consultation and between 40 and 50% for
homeopathic products, related to a recent hospital stay.
Reimbursement for homeopathic consultations
Nowadays, some sickness funds, like the Independent sickness funds and the Neutral
sickness funds, reimburse also the consultation with a homeopath. This reimbursement
is restricted to consultations by a physician and is also restricted in amount and number
of sessions (10 euros per consultation with a ceiling of 5 sessions of all nonconventional
medicines per year). In contrast to the recognition of the therapists of the
other non-conventional medicines, no additional criteria, next to the medical degree,
are set up for the homeopaths. These physicians are allowed to double reimburse their
consultation, partly by the compulsory health insurance for the ‘medical consultation’
itself, and partly by the complementary health insurance for the non-conventional
therapy.
The sickness funds do not provide any reimbursement for homeopathic products or for
the homeopathic consultation, provided by a non-physician-homeopath.
An overview of the results is given in the appendix.
5.6.4 Discussion
In the 10 years-period between the first announcement of the law Colla and the
execution of this law, the sickness funds regulate their own system of reimbursement of
the non-conventional medicines. This regulation went together with the auto-regulation
of the professional unions and schools in these medicines.
In general the reimbursement of non-conventional medicines is restricted to the
reimbursement of the provision of services. For homeopathy a particular
reimbursement system was set up, by determining a list of recognised homeopathic
products. The patient is more guided in the overwhelming offer of homeopathic
products and the safety of patient is more guaranteed by the supervision of the
physician.
Some sickness funds provide also reimbursement for the consultations by a homeopath.
The reimbursement is restricted in amount and number of sessions and is only for the
physician-homeopaths. But this system of reimbursement is in favour of the physicians.
Whereas the non-physician-homeopaths are not recognised by the sickness funds and
are not allowed to prescribe homeopathic products, has the physician-homeopath the
freedom to double count a same treatment session as a conventional therapy
(reimbursed by the compulsory health insurance) and a non-conventional therapy
(reimbursed by the complementary health insurance).