Expensive placebos work better than cheap placebos

Expensive placebos work better than cheap placebos. People's perceptions of the cost of a drug may affect how much they benefit from the drug, even when they are just receiving a placebo. That's according to a study of patients with Parkinson's disease published in the January 28 2015, online issue of Neurology®, the medical journal of the American Academy of Neurology.

For the study, 12 people with Parkinson's disease were told that they would receive shots of two formulations of the same drug, with the second shot given after the first shot wore off. They were told that the formulations were believed to be of similar effectiveness, but that they differed in manufacturing cost--$100 per dose versus $1,500 per dose. Participants were told that the study was intended to prove that the drugs, while priced differently, were equally effective.

In reality, the participants received a placebo for both injections but were told they were receiving either the "cheap" or "expensive" drug first. Before and after each shot, participants took several tests to measure their motor skills and also had brain scans to measure brain activity.

When people received the "expensive" drug first, their motor skills improved by 28 percent compared to when they received the "cheap" drug. On one test of motor skills, people's scores improved by seven points when taking the "expensive" drug first, but improved by only three points when taking the "cheap" drug.

In conclusion, the study proved that expensive placebo significantly improved motor function and decreased brain activation in a direction and magnitude comparable to, albeit less than, levodopa, the most potent medication for Parkinson's disease. Perceptions of cost are capable of altering the placebo response in clinical studies.

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