Ginkgo biloba in patients with decreasing mental performance, peripheral arterial occlusive disease, dizziness, or tinnitus
Ginkgo biloba is a herbal medicinal product that is thought to reduce inflammation, improve blood flow to the brain and help protect nerve cells from damage. In Switzerland, it is authorised and reimbursed for adults with mental performance deficits, peripheral arterial occlusive disease, dizziness, and tinnitus. This HTA report examines the clinical efficacy and effectiveness, safety, and budget impact of ginkgo biloba compared to a placebo, no treatment or a standard treatment.
A systematic literature review encompassing 42 clinical studies showed various results. People with mental performance deficits showed an improvement in cognitive ability (e.g. thinking and memory), in behavioural symptoms and in health-related quality of life following a 24-week treatment with 240 mg of ginkgo biloba compared with a placebo. Patients with peripheral arterial occlusive disease showed an improvement in their pain-free walking distance on a dose of 160 mg. For those with dizziness and tinnitus, treatment with ginkgo biloba showed no demonstrable benefit compared with a placebo or standard treatments. The results do not indicate an increased risk of adverse effects or serious side effects.
According to the analysis, the reimbursement of ginkgo biloba in Switzerland had a budget impact of CHF 167’154’958 over the five-year period. The costs for people with mental performance deficits amounted to CHF 56’912’066. A scenario analysis showed that for these people, switching to an alternative treatment would result in additional costs. For peripheral arterial occlusive disease, the costs amounted to CHF 29’956’227, for dizziness CHF 20’325’738 and for tinnitus CHF 59’960’927. The scenario analyses were based partly on expert opinions and should therefore be interpreted with caution. In terms of ethical, legal, social and organisational issues, the focus was on communication of the benefits and risks to vulnerable population groups and their access to treatment.
The report concludes that in people with mental performance deficits, a 24-week treatment with 240 mg of ginkgo biloba can lead to an improvement in cognitive ability (e.g. thinking and memory), in psychological and behavioural symptoms and in health-related quality of life.
Federal Office of Public Health FOPH
Health Technology Assessment Section
Schwarzenburgstrasse 157
Switzerland - 3003 Bern