March 04, 2008
Placebos More Effective If More Expensive?

People don't expect cheap drugs to help them much. No wonder the price of drugs has risen. People want more effective results.

DURHAM, N.C. -- A 10-cent pill doesn't kill pain as well as a $2.50 pill, even when they are identical placebos, according to a provocative study by Dan Ariely, a behavioral economist at Duke University.

"Physicians want to think it's the medicine and not their enthusiasm about a particular drug that makes a drug more therapeutically effective, but now we really have to worry about the nuances of interaction between patients and physicians," said Ariely, whose findings appear as a letter in the March 5 edition of the Journal of the American Medical Association.

Ariely and a team of collaborators at the Massachusetts Institute of Technology used a standard protocol for administering light electric shock to participantsí wrists to measure their subjective rating of pain. The 82 study subjects were tested before getting the placebo and after. Half the participants were given a brochure describing the pill as a newly-approved pain-killer which cost $2.50 per dose and half were given a brochure describing it as marked down to 10 cents, without saying why.

In the full-price group, 85 percent of subjects experienced a reduction in pain after taking the placebo. In the low-price group, 61 percent said the pain was less.

The conclusion here is obvious: Medical professionals need to go to greater lengths to deceive patients into believing that ineffective treatments really will work. At least for chronic pain this might help. I'm at least half serious.

Share |      Randall Parker, 2008 March 04 09:17 PM  Brain Economics

Brett Bellmore said at March 5, 2008 4:53 AM:

I've always been bummed out about the whole placebo thing. So much for the advantages of being smart and well informed: All it gets you is that a whole class of powerful drugs won't work on you!

I do hope that if doctors are going to start charging high rates for sugar pills, they at least find some way to feed the money back to the patient, perhaps accumulating it as a kind of medical savings account for when they need real drugs that cost a lot.

By the way, did you know your "wait before posting again" counts accidentally previewing against you?

You could also define "short time".

Bob Badour said at March 5, 2008 2:28 PM:

It won't work. By the time I was six years old, I had figured out that: "You may feel a slight discomfort" means "This is going to hurt like hell."

It might work for adults, but what do you do about the next generation?

clayton said at March 6, 2008 7:36 AM:

"The power of endorphins to fight pain has been well known since the 1970s, when it was found that the brain produces chemicals far more potent than morphine, opium and heroin."

from january of 07.

This new article does little but support the placebo effect. Not a bummer, good news really.

David Govett said at March 6, 2008 7:58 AM:

The fake placebo market remains unexploited.

Brett Bellmore said at March 8, 2008 5:35 AM:

It seems clear enough that, if the placebo effect is this powerful, the thing we ought to be doing is putting a lot more work into developing effective biofeedback equipment. You can learn to do pretty much anything through biofeedback that you can unknowingly do as a result of thinking a sugar pill is a medication, and some things you'd be hard put to convince a patient a pill would accomplish. The brain has a lot more control over the body than is commonly recognized, and what the brain can control, the conscious mind can learn to control, if given some kind of sensory cue as to what's happening.

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