Monday, March 10, 2008

Expensive Placebo Pills Work Better

An amazing study published in JAMA has shown that expensive placebo (dummy) pills work better than cheaper dummy pills. Researchers from Mass. Institute of Technology (MIT) recruited 82 healthy people. They said they were taking a new opioid pain pill that had been approved by the FDA. Instead they gave half the subjects a placebo pill that they said cost $2.50. They gave the same placebo to the other subjects but told them it cost .10 cents.

The researchers administered electric shocks (hope they got paid for this study!!!). Of the folks who took the $2.50 pill, 85% said it worked. Only 61% of the people who took the same placebo worth .10 cents said it worked.

The take home message for doctors is that we shouldn't be stressing how inexpensive medications are if we want people to improve. Generic Omeprazole has been shown to work as well as Prilosec for GERD. All of us have had patients who ask for the "Name Brand" (read expensive) because "It works better". It may work better because of its effect on the pocketbook rather than the body.

How we communicate may have more effect on healing than the drug itself.


Robbie Coull - GP, Scotland said...

I was struck by the NEJM study (ref on weblink below) showing that Glucosamine was almost as good as an NSAID.

What struck me was that placebo was almost as good as both of them.

I predicted then that placebo would be the next big thing - a kind of 'post-modern' alternative medicine (almost all of which is placebo).

Other research shows that drugs with an X or Z in the name are more effective (hence all the drugs with X and Z in the name - Big Pharma is not stupid).

I set up the spoof site SugaPil to try and highlight the topic in a humorous way.

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Placebo pills !!! what a wonderful stuff, I need a bunch to keep my hysterical girlfriend quiet.

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Cyril said...

This cannot succeed in reality, that is exactly what I suppose.
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