Placebo Study -- The More Expensive the Better it Works

Placebo study tests 'costlier is better' notion

Results of a study using sugar pills could explain the huge popularity of some big-brand medications such as Celebrex.
By JB Reed, Bloomberg News
Results of a study using sugar pills could explain the huge popularity of some big-brand medications such as Celebrex.
Even when it comes to identical sugar pills, some people think a costly one works better than a cheap one, a letter in the Journal of the American Medical Association says today.By Rita Rubin, USA TODAY

The letter describes a study funded by the Massachusetts Institute of Technology. Researchers recruited 82 healthy paid volunteers and gave them a brochure about a new opioid pain reliever described as similar to codeine, only faster-acting.

Volunteers were randomly divided into two groups. One group was told the new drug cost $2.50 a pill; the other was told it had been marked down to 10 cents a pill, although no explanation was given.

The researchers applied light electric shocks to the volunteers' wrists to see how much pain they could tolerate. The researchers administered the shocks before and after the pill was taken and asked subjects to rate the pain.

Of the patients who took the full-price pill, 85% said they felt less pain afterward, compared with 61% of those who took the 10-cent pill. Because both groups received the same sugar pills, the power of the placebo effect in pain relief was illustrated.

"What we experience is partially reality and partially what we expect to experience," says the senior letter author, Dan Ariely, a Duke University behavioral economist whose new book, Predictably Irrational, explores why people make the choices they do. "The more practical point is, how do we give discounted pain medications without hurting people?"

Authors speculate that their findings might help explain why anti-inflammatory Vioxx and Celebrex were huge sellers, even though there was no evidence they were any more effective at relieving pain than generic naproxen or ibuprofen.

The placebo effect of generics might not be as powerful as that of expensive brand-name drugs because of their lower price tag and their lack of a pedigree, Ariely speculates.

And people might be less likely to continue taking generics as prescribed because they haven't spent much money on them, he says.

Perhaps people who can't afford to pay for expensive drugs might respond better to treatment if prices were eliminated from the equation and they received them free instead of at a reduced cost, Ariel says.


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