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Second Nonnweiler Declaration

Reimbursement of the costs of mistletoe preparations used in adjuvant cancer therapy

Based on the present state of scientific knowledge and cognisant of the new research results discussed at the 5th International Symposium "Mistletoe in Cancer Therapy - Basic Research and Clinical Practice" held from 10th to 12th November 2011 in Nonnweiler, the participants of that symposium hereby declare that the costs of parenteral administration of mistletoe preparations not only in the palliative but also in the adjuvant therapeutic setting should remain reimbursable by the statutory health insurance (SHI) funds.

Clinical studies have shown that mistletoe preparations improve the quality of life of cancer patients and the tolerability of conventional cancer therapies (ref. 1-4). There is also evidence that the survival of cancer patients is prolonged (ref. 2, 4). As the studies concerned were performed both in adjuvant and in palliative therapy settings, restriction of reimbursability by the SHI scheme to palliative therapy of malignant tumours is not justified.

Despite this, such restrictions on the reimbursability of mistletoe preparations by the SHI scheme have been in force since the end of September 2011, based on the grounds given for the Federal Social Court's most recent ruling. As a result of this, effective, well tolerated, useful and cost-effective treatment with mistletoe preparations is being withheld from many patients in the adjuvant therapy setting.

Therefore, and in accordance with their ethical responsibility to the cancer patients whose care has been entrusted to them and who seek their advice, the representatives of the medical and pharmaceutical professions who are gathered together at this symposium call for treatment with mistletoe preparations to be made reimbursable by the SHI scheme in cases in which the physician considers such medicines to be a necessary component of oncological therapy.

References:

1. Kienle GS, Kiene H: Influence of Viscum album L (European Mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther 2010; 9(2):142-57. Volltext (PDF)

2. Kienle GS, Glockmann A, Schink M, Kiene H: Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Journal of Experimental and Clinical Cancer Research 2009; 28:79, DOI:10.1186/1756-9966-28-79. Abstract (PubMed) HTML Volltext (PDF)

3. Horneber M et al.: Cochrane Library 2008 (auch nachzulesen in Scheer et al.: Die Mistel in der Tumortherapie 2 2009, S. 295 ff, KVC-Verlag Essen.

4. Kienle GK, Kiene H: Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts. Eur J Med Res 2007, 12:103-19.  Volltext (PDF)

Nonnweiler, 12. November 2011

On behalf of the scientific associations, organisers and participants of the 5th Mistletoe Symposium signed by:

Prof. Dr. Susanne Alban, Deutsche Pharmazeutische Gesellschaft (DPhG)

Prof. Dr. Hans Becker, Universität des Saarlandes

Prof. Dr. Wolfgang Blaschek, Gesellschaft für Arzneipflanzen- und Naturstoff-Forschung (GA)

Dr. Thomas Breitkreuz, Gesellschaft anthroposophischer Ärzte in Deutschland (GAÄD)

Dr. Maria Frühwald, Karl und Veronica Carstens-Stiftung

Prof. Dr. Dr. h.c. mult. Fritz H. Kemper, Gesellschaft für Phytotherapie e.V. (GPT)

Prof. Dr. Wolfgang Kreis, Universität Erlangen-Nürnberg

PD Dr. Harald Matthes, Hufeland-Gesellschaft

Prof. Dr. Dr. h.c. mult. Heinz Schilcher, Zentralverband der Ärzte für Naturheilverfahren und Regulationsmedizin (ZAEN)

Dr. Rainer Stange, Zentralverband der Ärzte für Naturheilverfahren und Regulationsmedizin (ZAEN) und Gesellschaft für Phytotherapie e.V. (GPT)