Medicines containing valerian for treating symptoms of insomnia, mental stress and test anxiety (HTAValerian)

This Health Technology Assessment, commissioned by the Federal Office of Public Health, examines the efficacy, safety, cost-efficiency and budget impact of valerian-containing medicines for insomnia, mental stress and test anxiety compared with placebo, other therapies or no treatment.

Result

Key data

Result

The systematic literature review and meta-analyses found insufficient evidence for a consistent effect of valerian-containing medicines over placebo across most outcomes.

A statistically significant benefit over placebo was observed for sleep quality at post-intervention and for the total PSQI score. For most other outcomes assessed, including sleep latency, sleep duration and sleep efficiency, no consistent superiority over placebo could be demonstrated.

The safety profile of valerian was found to be favourable.

The budget impact analysis, based on real-world health insurance claims data (SASIS, SWICA) and a survey of Swiss general practitioners, estimated potential savings of approximately CHF 220 to 245 million over a five-year time horizon, depending on the scenario, if reimbursement of valerian-containing medicines under mandatory health insurance were discontinued.

The accompanying ELSO analysis identified several relevant issues related to a potential change in reimbursement, including questions of care continuity for vulnerable groups and the relationship between traditional use and regulatory efficacy requirements.

Description

Valerian is a herbal medicine that has gained popularity as a calming and sleep-promoting alternative to prescription drugs, although the evidence on its clinical efficacy remains inconsistent in the literature.

Commissioned by the Swiss Federal Office of Public Health (FOPH), ZHAW conducted this Health Technology Assessment to systematically examine the efficacy, safety, cost-efficiency and budget impact of valerian-containing medicines for insomnia, mental stress and test anxiety, compared with placebo, other herbal medicines, cognitive behavioural therapy, other medicines or no treatment.

Alongside a systematic literature review with meta-analyses, the project included a survey of general practitioners and an analysis of ethical, legal, social and organisational aspects.