The placebo effect has always been a bit of a mystery to science. Give patients a pill filled with sugar or in an injection of saline but tell them it’s medicine, and a percentage of them will report feeling better.
A recent study in a handful of Parkinson’s patients suggests you can boost the effects of the placebo even further by telling patients the drug costs a lot of money.
In the experiment by Alberto Espay and his colleagues at the University of Cincinnati, the patients received saline but were told they were testing the efficacy of two real drugs – one that cost $100, and another that cost 15 times as much.
“When they received the cheap formulation, they got better, but nowhere near those who received the expensive medication,” Espay says.
In fact, the people who thought they were getting the expensive drug did almost as well as when they were on a real drug. What the patients experienced was real, but it was entirely due to the placebo effect.
Espay believes that cost affects the placebo because so many of us believe that expensive things are better.
“We feel the more be pay, perhaps the more value we’re getting,” he says. “And of course that isn’t true.”
It isn’t true, unless we believe it is, explains George Newman, a professor of psychology at Yale School of Management whose research has demonstrated that the pleasure we get from objects is determined by what we believe about them.
For, example, if we believe we are drinking a $200 bottle of wine, it tastes better, and the regions of the brain devoted to pleasure light up more brightly than if we think it’s a bottle of Two-Buck Chuck.
“What we’re believing about the world, what we’re imagining about the word directly effects how we experience things even very tangible things like the effectiveness of medication,” Newman says.
In this case, cost creates a bias in patient’s expectations, says Ted Kaptchuk, director of the placebo studies program at Beth Israel Deaconess Medical Center. And that’s not necessarily a bad thing.
“But it’s a bias we want to utilize, we want to maximize,” Kaptchuk says. “We want to optimize in clinical practice.”
But before drug manufactures start raising prices in the name of science, Kaptchuk says there are plenty of ethical ways to raise patient expectations. And most of them, like improvements in listening and attentiveness by physicians, are free.