Placebo Power Grows, Perplexing Big Pharma

It's a real challenge developing better drugs for loads of common conditions because there are already so many effective treatments.

Active or inert?

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But another problem that might surprise you is that placebos, the dummy pills that are the gold standard for comparison in drug studies, seem to be getting more powerful. A provocative piece in Wired describes the evolving science behind placebos and the relatively recent finding that patients' response to sugar pills in many studies appears stronger than it used to be.

Psychiatrist and drug researcher William Potter, now at Merck, found that antidepressants, including Prozac, were more likely to fail when compared to placebos in trials conducted recently than in studies a decade earlier. Results also varied by location and according to doctors' subjective interpretation of supposedly standardized measures of response.

There's so much to learn about placebos, the National Institutes of Health convened a conference nine years ago to tee up a research agenda. You can watch video from the NIH conference in 2000 here.

Now, Wired writes, Potter and colleagues in the drug industry are dredging decades of clinical testing data to figure out what's driving the rise in placebo power. Called the "Placebo Response Drug Trials Survey," the project is funded by some of the biggest names in the drug industry.

Doctors already know that placebos can get the job done and commonly prescribe them to patients. Few physicians resort to actual sugar pills, but about half of American internists and rheumatologists regularly prescribe some sort of placebo, according to a survey published last year in the BMJ. The placebos of choice: over-the-counter painkillers and vitamins.