Purpose: Some researchers have suggested that the popularity of complementary and alternative medicine (CAM) in the United States is due, in part, to the growing cost of conventional medical care. The 2011 National Health Interview Survey is the first population survey that directly asks respondents if they have substituted alternative therapies for prescription medications. The purpose of this study was to estimate the adult prevalence of CAM substitution and to identify factors associated with cost-related CAM use. Methods: The sample adult core component of the 2011 National Health Interview Survey (N = 33,014) included a number of questions about prescription medication access and use, including "in the past 12 months, did you use alternative therapies to save money?" We used the Behavioral Model of Health Services Use to identify factors associated with the use of alternative therapies among respondents. Multivariate logistic regression models were used to evaluate factors associated with cost-related CAM use. Findings: An estimated 12.3 million adults (5.4% of the population) used alternative therapies to save money in 2011. Women, middle-aged (31-50 years) adults, and residents of the western United States were more likely to engage in CAM substitution, as were smokers, those with activity limitations, and those in fair or poor health. The highest rates of CAM substitution were reported by uninsured adults (11.9%). Implications: A sizable number of adults in the United States use alternative therapies because they are cheaper than prescription medications. The health risks of such CAM substitution can be serious, and the phenomenon merits further investigation.
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