Cheap is just not working

23. April 2008
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Just the industry profits from expensive drugs? Nonsense! A study made by US placebo researchers now shows that patients are judging the efficiency of pills by its price as well. Unnoticed, unknowingly and whether they want it or not...

The behavioral economist Dan Ariely at the US-American Duke University has lost his illusions about medicine long time ago: “Physicians like to think that it’s the ingredients making a drug effective”, says Ariely.
The latest example for the complex processes at this interpersonal interface Ariely delivered himself in a study researching the placebo-effect of painkillers on a total of 82 test persons. He reported in the Journal of the American Medical Association.

Stinginess is not hot at all

The test had the classical design of placebo-studies: The participants were exposed to pain stimulation, in this particular case to a minor electric shock applied at the wrist. They quantified the intensity of pain by standard gamut. Afterwards they received a placebo-pill and a brochure describing the alleged drug in greater detail. A part of the test persons received a brochure praising the drug as a brand-new, just registered medicament containing a modern ingredient and costing two and a half Dollars per pill. The rest of the test persons received a brochure explaining that the drug is older and just costs 10 Cents per pill.
The result: 85 percent of those test persons persuaded of the drug being new and expensive reported lower pain intensity “after pill”. On the other hand, only 61 percent of the test persons convinced that they had swallowed a 10-Cent-Oldtimer, reported of pain reduction. “This result fits well into the existing data how people apprehend quality and how they anticipate therapeutic effects” emphases Ariely.
The scientist himself contributed to this datapool effectually with own studies at the Massachusetts Institute of Technology. About two years ago in the “Journal of Marketing Research”, he reported on several experiments showing beyond medicine that the judgment of the customer regarding the quality of the products can be influenced within certain limits by the price. For that he invented a drink named “SoBe Adrenaline Rush”, similar to Red Bull, supposedly increasing the brain performance. Afterwards the probands – in this case students – were supposed to tackle various logical puzzles: “It showed that a fictive price reduction on a product supposedly increasing the mental performance affects the number of correctly put puzzles negatively”, says Ariely.

When it comes to drugs – never play it cheap!

It is obvious that such results are quite interesting for physicians as well as for the pharmaceutical industry. In randomized-controlled studies the placebo-effect is supposed to “bowdlerize itself” – in the ideal case. But at least in the field of post-marketing, the felt efficiency could be enhanced by adequate pricing and according marketing as a modern innovative product.
By the same token, physicians now have a tool at hand: An honest soul trying to convince his patients about a time-tested and more cost-effective drug just like that, might do a disservice to his potential therapy success.
Another study published in the Journal of General Internal Medicine shows that physicians are quite prepared to utilize the placebo-effect not just in a suggestive area, which proved a poll with 466 internists in the larger Chicago area of which 231 replied. After all, 45 percent of the physicians reported that they deliberately prescribe placebo occasionally. It is interesting what those physicians tell their patients. One third “sells” the pseudo-pill by saying: “Here’s a drug that might help and for sure won’t do any harm”. Another third tells them: “Here’s a pill that will help, but I am not sure how it works.” At least, four percent choose the frontal attack and tell their patients that they are getting a placebo. If that possibly helped?

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