Why “Expensive” Medicines Might Actually Work Better

Perceived cost might influence drugs’ benefits

Pills
Masterfile/Corbis

Do expensive drugs work better than cheap ones? Hold onto your wallet—new research suggests that how much you think a drug costs could impact how much you benefit from it…even if it’s a placebo.

A team of Parkinson’s researchers and neurologists were curious about how cost contributes to the perceived impacts of treatments. They told 12 Parkinson’s patients that they would give them two different formulations of the same drug—one that cost $100 per dose and one that cost a whopping $1,500 per shot. After telling them whether they were being given the “cheap” or “expensive” drug, researchers injected the subjects with harmless saline solution instead. Once the drug “wore off,” they injected them with the other solution before subjecting them to a barrage of neurological tests.

The result was impressive indeed: patients who though they’d been given the “expensive” drug first showed a 28 percent improvement in motor skills. And after the researchers revealed that the drugs were actually placebos, the patients who confessed to expecting the “expensive” drug to do better ended up being the same ones who exhibited the biggest benefits.

Though the results could be skewed by the fact that the tests were performed on Parkinson’s patients, who are known to release more dopamine in response to placebos, researchers think the results might apply to others, as well. “People who receive the shots thinking they received a drug may have an ‘expectation of reward’ response,” explains study lead Alberto J. Espay in a news release. That expectation can cause the brain to release dopamine in an amount that’s similar to that generated by the reward itself, he notes.

Since the study relied on deception to get its results, the team had their plans reviewed and approved before they lied to patients about the placebo injections. But did patients really need to be deceived to feel the placebo effect?

In a 2010 study, a team of researchers found that a group of patients who took pills clearly labeled “placebo” to treat irritable bowel syndrome were twice as likely to feel relief as those who didn’t receive treatment at all. Perhaps the mere act of being treated—or the specter of a big bill—is powerful in and of itself.

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