"Expensive" Placebos Work Better Than "Cheap" Ones

A new study published in the American Medical Association has a new and astonishing demonstration of just how much your perception becomes your reality when it comes to prices. People in the study thought they were trying out a new kind of pain med. Instead, they got sugar pills. However, some were told their sugar pills cost $2.50, and the others were told the pills cost $0.10. People with the “pricey” sugar pill had their pain reduced much more than the “cheap” sugar pill. Does this mean that price alone pays for itself?

(Thanks to Cheryl!)

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  1. Jericho114 says:

    Like a wise man once said. “It’s all in your head.” Believe it.

  2. scarletvirtue says:

    It almost doesn’t surprise me. People assume that because something is more expensive, it works better. Riiight.

    I’ll admit that I’m kind of a cheap-ass when it comes to meds, so I don’t care if a med is brand or generic. Actually, I kind of lean towards generics, since they work just as well as the brands.

  3. TechnoDestructo says:

    Wow, so drugs must be a lot more effective in the United States than in the rest of the world, right?

    Or is it cost in terms of percentage of income, so drugs are most effective in Sub-Saharan Africa?

  4. scarletvirtue says:

    @TechnoDestructo: Ha! If only that were true.

    I’m not sure how it works, I just think that the whole system sucks.

  5. cde says:

    So…. this is kinda like a placebo-placebo effect?

  6. dweebster says:

    So this means my outrageously expensive HMO plan will get me much healthier than a lower-priced plan, eh?

    I’m gonna ask them to double my rates and I’ll live FOREVERRRRRRR!

  7. Landru says:

    I love my Airborne.

  8. itsallme says:

    Does anybody know how to make placebos out of coat hangers? There’s another test I want to conduct.

  9. Spamwich says:

    @itsallme: Oooooooh, even I cringed at that one :

  10. Myotheralt says:

    um, you *can* buy happiness?

  11. backbroken says:

    cde: Exactly right!

  12. ironchef says:

    just ask kevin trudeau.

  13. bohemian says:

    Hmm the drugs that I have had better bang for the buck are usually cheap generics. So do my drugs become less effective when my copay goes down?

    That $10 inhaler I bought in Mexico worked just as good as the one I bought in the states for $199.

  14. karmaghost says:

    Perception is incredibly strong. You can get more drunk in an unfamiliar place than a familiar place by drinking the same amount of alcohol.

  15. ninjatales says:

    Do you get a “placebo” rebate once you’re “cured”? People shouldn’t be getting hundreds of $$$ charged to their insurance accounts for sugar pills.

  16. brainologist says:

    This is the same effect as the story you guys covered earlier. There was an article in the journal Proceedings of the National Academy of Sciences showing brain activity in reward regions (i.e. people’s sense of pleasure) was higher when they thought they were drinking expensive wine than cheap wine… regardless of how good the wine actually was.

    Your mind has a very powerful influence on your body.

  17. chatterboxwriting says:

    @ninjatales: It was a research study, so the pills were probably provided to the participants free of charge. They may even have been compensated for their participation.

  18. azntg says:

    Placebo? Isn’t it a drug manufactured by Pfizer? ;-)

  19. Orv says:

    @chatterboxwriting: Right. The people weren’t actually charged the money, they were just told what the pills cost.

  20. TechnoDestructo says:

    @azntg:

    “WHERE CAN WE GET THESE PLACEBOS?

  21. Advisor7 says:

    Please see a new book by Dan Ariely, Predictably Irrational, “Chapter 10: The Power of Price — Why a 50-cent Aspirin Can Do what a Penny Aspirin Can’t. An MIT professor, Ariely is a behavioral economist, i.e., through experiments he investigates how we make choices and assign values. Placebos work because of belief and conditioning. He also provides some advice: we should carry out many more placebo experiments to distinguish treatments of real power from those that only seem to work.

  22. Brian Gee says:

    @scarletvirtue: Its chemistry. The generic drugs are *exactly* the same stuff as the name-brand. They just don’t have the same marketing budget. They don’t just “work just as well”, they’re the EXACT SAME STUFF. We’re not talking Coke vs Pepsi. We’re talking Coke and “Coke in an unlabeled glass”.

    I was in line at Walgreen’s once and overheard the lady in front of me complaining, “I don’t pay for generic drugs. I want the name brand.” It was all I could do to not beat some sense into her (and then buy her a bottle of store-brand ibuprofen); how she chooses to waste her husband’s fixed income (seriously… if it was really *her* money, she’d be getting generics like everyone else) is none of my business.

    @bohemian: your copay only affects the effects if you’re an idiot. The drugs, generic or not, do whatever it is they are made to do (whether or not what they do is known or understood, hence the volumes of side-effects). Same bang, less bucks; generics win every time.

    The mind may be powerful, but sometimes drugs really do help. I just wish the “health” industry was more interested in helping people than making a quick buck. I’m sure the lack of trust in our providers does a lot more harm to our collective health than any miracle cure could overcome.

  23. cde says:

    @Brian Gee: Calling someone an idiot because of a psychological placebo effect is pretty harsh.

  24. no.no.notorious says:

    i heard about this a couple days ago. very interesting.

  25. bohemian says:

    @Brian Gee: I was being snarky. What I find interesting, I have been contacted about two medical studies being done by doctors, not drug companies. One uses a fairly cheap OTC supplement. The other uses a low dose of a cheap generic drug that has been on the market for 30 years.

    I am starting to get the feeling that the medical community has become fed up with the drug companies putting big profits ahead of cheap but effective options.

  26. This is because many illnesses and chronic pain are caused by your brain.
    “The Mindbody Prescription” or “The Divided Mind” by Dr. John Sarno, talk about this subject in depth.

    I had horrible sciatica for a year. Di all kinds of treatments costing me a small fortune. Read a Sarno book that cost me ten bucks, and in two weeks I had gotten about 75% better. I actually went to Dr. Sarno after that and took a class with him. After that, I have been in complete control of my pain any time stress makes it start to come back.

  27. CumaeanSibyl says:

    I think it’s important to work on the psychological level with all pain, even though I don’t believe that it’s all in your head — even if you’ve got, say, a broken leg, you can still be fooled out of some of that pain.

    Ever notice how a lot of prescription painkillers don’t necessarily make the pain go away, they just disconnect you from it? Whenever I’ve had hydrocodone or whatever after an operation, I found that I could still feel the pain — I just didn’t care, because I was high.

  28. MTHarden says:

    This is why it is a bad idea to use placebo controls in studies of pain medicine efficacy. A ‘hidden’ administration of experimental and control medications is a much more reliable test.

    And not just for pain, a recent study in PLoS Medicine made bold claims about SSRIs (Prozac and it’s ilk) being all (or at least mainly) placebo effect when treating depression. Science!

  29. TechnoDestructo says:

    @Brian Gee:

    I seem to recall reading…maybe it was here…something about how SOME generic drugs may be the same drug, in the same quantity, but the inactive ingredients may be different and the pill may have a different structure, which affects how the drug is delivered.

    So maybe it’s coke in a 12 oz plastic bottle vs shotgunning a 12 oz can of coke.

  30. LUV2CattleCall says:

    Sugar Pill? Good thing they weren’t trying out a dia-beetus medication!

    @Brian Gee:

    That’s what your insurance company wants you to think… I’ll agree that for the most part, they have the same exact effect, but the name brands have different fillers than the generics – neither is necessarily better. In some cases, a patient could be allergic to a lactose-containing filler in a name brand but ok with the talc-based filler in a generic.

    Also, Approval of a generic version of a name brand drug by the FDA requires demonstration of chemical equivalence – similar quantities and availability of the active ingredient in name brand and generic drugs within a set period of time – and “bioequivalence” – defined by absorption parameters generally falling between 80% and 125% of those obtained with the name brand drug under the same testing conditions. That’s a whopping 45% spread!

    Most of my family is in the medical field and my mom works for the VA; an good example is a patient that did poorly on Metformin but did great on Glucophage. He also had Alzheimer’s and wasn’t really aware that they switched from generic to name brand, to the “expensive pill effect” isn’t in play. I personally do much better on name-brand ADDerall because that +/- 15% is more than enough to mess things up.

  31. shoegazer says:

    @LUV2CattleCall: I guess the question is whether the +/-15% difference is worth a 300% markup. With some speciality drugs like my mother takes, the markup is more like 2000%. Yes, the name brand drug costs 20 times MORE than a generic.

  32. DiscoJesus says:

    @LUV2CattleCall:

    Some generic drugs have a noticeable difference in their effectiveness versus their brand name equivalent. Funny you mention Adderall as well. I’ve noticed a (not huge but decent) difference between the Sandoz Labs generics and the Watson generics.

  33. vladthepaler says:

    Actually, the study was published in the Journal of the American Medical Assocation (JAMA). Full text is available at:

    jama.ama-assn.org/cgi/content/full/299/9/1016

  34. LUV2CattleCall says:

    @shoegazer:

    It’s more so the fact that you have no clue if a certain tablet has a + or – 15% difference, which in some cases can be worse than taking nothing at all.

    @DiscoJesus:

    Just be glad you don’t get any pills by Barr… they tend to be a bit more lax compared to some of the other companies.