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Medication costs play into placebo effectiveness

A new study has found that patients correlate the cost of medication to how effective that drug will be, which in turn alters how their bodies respond — even if it’s a placebo, according to Neurology, a medical journal from the American Academy of Neurology.

The study, led by a research team from the University of Cincinnati in Ohio, tracked 12 people with Parkinson’s disease. The patients were told that they would receive two shots of the same drug, with the second shot given after the first injection wore off. Although the administered medication were of the same drug and are believed to be equally effective, the patients were informed each was a slightly different concoction, and each medication differed in manufacturing cost, with the cheaper version coming in at $100 per dose versus $1,500 per dose for the expensive version. Participants were led to believe that the intention of the experiment to prove that the drugs, while priced differently, were equally effective.

The expectations patients have in a medication and treatment method directly affects how effective their treatments will be, even when the medication itself isn’t actually real. The placebo effect has been heavily studied in people with Parkinson’s disease, which is why they were used, said study author Alberto J. Espay, MD, MSc, of the University of Cincinnati in Ohio and a Fellow of the American Academy of Neurology, in a press release. The real purpose of the experiment, unlike what subjects were told, was to discover whether what people thought about the cost of a drug they received affected the placebo response in the patients.

Patients’ perception of a drug’s effectiveness impacts treatment methods, drug options and hospital efficiency. Discovering the factors that affect a patient’s responsiveness to certain medications and stimuli is an important aspect of cost-effective patient treatments and hospital pharmacy automation.

The research the University of Cincinnati in Ohio team gathered will benefit these tasks, but there was actually no drug involved with any part of the experiment. Instead, the participants received a placebo saline solution for both injections; however, they were told that 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, the release states.

When people received the expensive placebo first, their motor skills improved by 28 percent compared to when they received perceived cheaper version. Additionally, participants’ scores on one of the motor skills tests improved by seven points when taking the expensive drug first, but improved by only three points when taking the cheap drug.

The researchers said they hope these findings can lead to new strategies where it’s possible to harness the placebo response to enhance the benefits of treatments, which would allow physicians to potentially maximize the benefit of treatment while reducing the dosage of drugs needed and possibly reducing side effects.

Because the study involved intentionally lying to patients, it received additional scrutiny from the University of Cincinnati in Ohio’s review board before getting approved. After the study was finished, researchers told participants about the true nature of the study.

The responses were a bit surprising. Eight of the participants said they did have greater expectations of the expensive drug and were shocked at the extent of the difference brought about by their expectations, instead of any real medication. Conversely, the other four participants said they had no expectation of greater benefits of the more expensive drug, and they also showed little overall change in comparison to the other group or when they began the experiment.

Information for this report was supplied by Science Daily and the American Academy of Neurology.

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