Expensive placebos are more effective

The Pediatric Insider

© 2010 Roy Benaroch, MD

A simple study from the March, 2008 issue of the Journal of the American Medical Association illustrates something important about the way we perceive the effectiveness of medication.

82 adult volunteers were recruited. They were told they were taking part in a trial of a new pain medication, testing its effectiveness using a standardized, well-established protocol using low-voltage shocks as a painful stimulus.

All of the pills were placebos.

Nevertheless, most of the study participants were able to tolerate higher intensity electrical shocks after taking the pill. And the ones who were told that the pill cost $2.50 found their placebo more effective than the volunteers who were told that their medication costs 10 cents.

Details: 85% of the participants taking the “expensive” placebo found it effective, versus 60% for the cheapo pill.

The authors conclude that one way for clinicians to help patients enjoy the benefits of their generic medication is to de-emphasize the price. By not dwelling on the inexpensive price of certain drugs, they might seem more effective. Of course, the converse is also true: why not deliberately prescribe the most-expensive, newest medication because it’s somewhat more likely to be perceived as effective, even if it’s no better at all?

The costs of a medication have no bearing whatsoever on how effective it might be. Don’t let Jedi Mind Tricks fool you into wasting money on the fanciest New Kid on the Block without real evidence that it really is better than a well-established, safe generic.

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