As family income went up, out-of-pocket spending on complementary approaches went up significantly. The average per user out-of-pocket expenditure for complementary health approaches was $435 for people with family incomes of less than $25,000, and $590 for those with family incomes of $100,000 or more. Out-of-pocket expenditures for visits to complementary practitioners averaged $314 for people with family incomes of less than $25,000 and $518 for those with family incomes of $100,000 or more.Americans spent $14.7 billion out-of-pocket on visits to complementary practitioners such as chiropractors, acupuncturists or massage therapists. That is almost 30 percent of what they spent out-of-pocket on services by conventional physicians. They spent more on visits to complementary practitioners than on natural product supplements or self-care purchases, and the mean annual out-of-pocket expenditure for practitioner visits was $433. Americans spent $12.8 billion out-of-pocket on natural product supplements, which was about one-quarter of what they spent out-of-pocket on prescription drugs. The mean annual out-of-pocket expenditure in this category was about $368. Total spending on purchases related to self-care approaches (for example self-help materials, such as books or CDs, related to complementary health topics) was $2.7 billion, and the mean annual out-of-pocket expenditure per user was $257.
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