Study Sheds More Light on 'Placebo Effect'

A new study indicates that people get better results from taking expensive pills — even when the "expensive pill" is a placebo with no active medical ingredients.

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People may prefer to lose weight instead of losing money, but when it comes to taking medicine, people apparently feel better after losing the money; that's according to a study in this week's journal of the American Medical Association. It finds that people get better results from a more expensive pill, even if it has no active ingredients. When NPR's Richard Knox checked out that finding, he was in for a shock.

RICHARD KNOX: We all buy on price when we're not sure how else to value something. Think of your latest trip to the wine store. Researchers at MIT wanted to test how this works with medications. They made up a phony pain killer they called Valodon(ph) and invited unknowing research subjects to try it out. Graduate student Rebecca Waber.

Ms. REBECCA WABER (Graduate Student): Valodon was described as a recently FDA approved drug in the opioid family, similar to codeine that was being used particularly in dental surgery.

KNOX: To make it more realistic, the researchers even made up Valodon pens like the ones drug companies hand out, and slick brochures.

Ms. WABER: People were given a brochure which listed one of two prices, either the full price or a discounted price.

KNOX: The supposed full price was $2.50 a pill. The discount price was 10 cents. People took the pill, waited 15 minutes for it to take effect, then got a series of electrical shocks to test their pain response. The result?

Ms. WABER: The placebo pill was more efficacious when it was not discounted.

KNOX: By how much difference?

Ms. WABER: In the higher priced condition, 85% of people experienced reduction in their pain between the two rounds, but only 61% of people did when they were in the lower priced condition.

KNOX: The experiment raises some interesting questions. For instance, when people shell out a $10 co-pay for a drug that really costs $300 for a month's supply, will it work as well as if they knew the real price? It might help explain why pricier painkillers like Celebrex become blockbuster drugs.

Ms. WABER: Why do they get so popular when clinical trials basically said they shouldn't have been so much better than Aleve or something else over the counter? You know, why did they get prescribed so much? Why did people say they liked them so much better?

KNOX: Maybe because they not only cost more, but because they were the latest and greatest. Behavioral economist Dan Ariely is Rebecca Waber's mentor and a study co-author. He says doctors might use the price placebo effect to get more bang out of the pharmaceutical buck.

Dr. DAN ARIELY (MIT): I think they could do it by getting them excited about the medication and when they give them something on discount, let's say there are two drugs, rather than having a discussion with them and saying, you know what, I'm going to give you the cheap one, don't focus on the price as a physician, but tell them I'm giving you this one because I think it's better for you.

KNOX: Before I left the MIT lab, I ask Waber to let me see how much pain her research subjects experienced. So she wired me up to her machine and gave me a series of shocks.

Ms. WABER: Is that enough?

KNOX: Enough? Ahh!

Ms. WABER: Okay. All right. That's high enough, I think. I think the scream is good enough.

KNOX: Yeah, that was good enough.

Ms. WABER: All right.

KNOX: Thank you.

Ms. WABER: You're welcome.

KNOX: It did hurt, but maybe that's because I hadn't taken a placebo first.

Richard Knox, NPR News, Boston.

INSKEEP: And that's your health for this Thursday morning. From hormone replacement therapy to flu vaccines, you can find the latest health news at npr.org/yourhealth.

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