Placebo Discount
Published: 2021-03-28
Tags: economics, medicine
Abstract
A proposal to monitize the placebo effect by selling, at a discount, bundles of doses of an effective drug that includes a certain percentage of placebo doses.
The placebo
effect
https://www.nccih.nih.gov/health/placebo-effectPlaceholder description for
https://www.nccih.nih.gov/health/placebo-effect
is a
well-studied
https://www.medicalnewstoday.com/articles/306437#how-does-it-workPlaceholder description for
https://www.medicalnewstoday.com/articles/306437#how-does-it-work
and
used
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524103/Placeholder description for
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524103/
effect of a placebo intervention on a recipient who expects the
intervention to be active. A placebo intervention is a medical
intervention (most commonly a drug administration) that is considered
directly inactive yet turns out to be indirectly active, with respect to
the patient's expectations. One of the most interesting aspects of the
placebo effect is how powerful it is -- many times the non-placebo
effect of common drugs is only slightly higher than the placebo!
Examples of the effectiveness of placebo versus non-placebo:
nasal congestion medicine
https://pubmed.ncbi.nlm.nih.gov/26143019/Placeholder description for https://pubmed.ncbi.nlm.nih.gov/26143019/
antidepressants
https://bmjopen.bmj.com/content/9/6/e024886.fullPlaceholder description for https://bmjopen.bmj.com/content/9/6/e024886.full
migrane medicine
https://pubmed.ncbi.nlm.nih.gov/24401940/Placeholder description for https://pubmed.ncbi.nlm.nih.gov/24401940/
nerve pain treatments
https://journals.lww.com/pain/Fulltext/2015/12000/Increasing_placebo_responses_over_time_in_U_S_.27.aspxPlaceholder description for https://journals.lww.com/pain/Fulltext/2015/12000/Increasing_placebo_responses_over_time_in_U_S_.27.aspx
Surveys of placebo effectiveness and usefulness:
Questionnaire survey on use of placebo
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524103/Placeholder description for https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524103/
Placebo interventions in practice: a questionnaire survey on the attitudes of patients and physicians
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026149/Placeholder description for https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026149/
Patients’ attitudes about the use of placebo treatments: telephone survey
https://www.bmj.com/content/347/bmj.f3757Placeholder description for https://www.bmj.com/content/347/bmj.f3757
While the power of the placebo effect is well-recognized and used
prolifically by randomized, placebo-controlled clinical trials clinical
trials (usually considered the "gold
standard
https://www.nccih.nih.gov/health/placebo-effectPlaceholder description for
https://www.nccih.nih.gov/health/placebo-effect" of
clinical trials) to determine the efficacy of medical interventions,
placebos are not used in consumer products such as over-the-counter
drugs. Why not take advantage of the placebo effect in consumer products
by offering bundles of placebo and non-placebo doses to buy? Well, there
are a few reasons I can think of:
- users assume they are taking a placebo, so will not worry about side-effects or mixing drugs
- users assume they are taking a placebo and so experience an adverse
nocebo effect
https://pubmed.ncbi.nlm.nih.gov/30118338/Placeholder description for https://pubmed.ncbi.nlm.nih.gov/30118338/
- users feel scammed if it is not clear that some amount of the drug they are buying is just sugar pills
- pharmacuetical companies use manipulative marketing to advertise placebos in order to cut costs of producing the non-placebo drug
- the placebo effect wanes when the user actively chooses to buy a bundle that includes placebos rather than the regular non-placebo
And I'm sure there are other issues that I am not thinking of.
Overall, if these issues are adequately adressed, I think that the value of the placebo effect to provide useful treatments at a low cost is likely to be much larger than the detriments to however much of the issues are not addressed (this calculation is included in the "adequately" qualifier).
I can imagine a deal where a drug is sold in two versions:
- Deal 1: the current deal, where a pack contains just doses of the FDA-approved drug
- Deal 2: the novel deal, where a pack contains 50% placebo and 50% non-placebo doses of the FDA-approved drug
Deal 2 takes advantage of the placebo effect since, among the doses included in the pack, the placebo and non-placebo doses are not distinguished. For the sake of safety, however, the same instructions and warning for taking doses of the drug also apply to taking doses from a deal 2 pack.
Deal 2 could be offered a somewhere in the range of a 35-45% discount to reflect how marginal production is roughly half the cost that of deal 1. This could be called the placebo discount! It's a win-win since the buyer at a lower cost takes advantage of the placebo effect (which is often comparable to the non-placebo effect of the drug) and the seller makes rougly the same (or perhaps slightly more) profits as if they sold a deal 2 pack.
References
placebo effect
well-studied
used
nasal congestion medicine
antidepressants
migrane medicine
nerve pain treatments
Questionnaire survey on use of placebo
Placebo interventions in practice: a questionnaire survey on the attitudes of patients and physicians
Patients’ attitudes about the use of placebo treatments: telephone survey
gold standard
nocebo effect