Placebos Gaining Market Share

Wired has a great feature on the placebo effect. Pharma is paying more attention as more and more drugs are losing to the placebo. And it isn't because the drugs are less effective. They have the expected positive effect. Thing is, the placebo has recently started to have an increased positive effect to rival that of the drugs.

If that's the case, could doctors just make the judgment call to prescribe a placebo in some cases and see what happens? You have a tough-to-place pain in your arm. Doc tries a few things and then decides to prescribe Panaceanol(tm), a new Merck placebo that is just sugar. A week later, you feel fine. You've triggered your own body's ability to deal with the injury/illness, introduced fewer chemicals, and done so more cheaply. The cost was, in part, having to fool you into doing it. Is it worth it?

Most importantly, is there any way to permit Drs. to do while mitigating any chance for abuse?


David said...

Wouldn't there be a medical ethics issue with (a) lying to patients and/or (b) using them as a control group without their consent?

bachrach44 said...

There are ethical issues with that (as David points out), and review boards will not approve such studies. (Although they have been done in the past). Usually when they want to study this, they ask for the patients consent to enter them in an experimental treatment program, with the understanding that experimental implies that it may not work. If the patients read the fine print they do find out that there is a chance they'll get a placebo, but the patients will never know for sure.

bachrach44 said...

I should mention that the above applies to studies. You can always prescribe a sugar pill and simply not say that it's a sugar pill. Doctors are allowed to do this on an ad-hoc basis AFAIK. They can't lie about it and say it's a pain killer, but they can say something like "I don't know how this works, but it might help and it won't hurt" (which is entirely true).

Incidentally, if you ever get prescribed something called cebocap, it's a prescription placebo that is carried by pharmacies and the like as if it were a real drug.