Cost of treatment as a placebo effect in psychopharmacology: importance in the context of generic drugs.
Nonspecific factors have long been known in both psychotherapy and psychopharmacology. In recent years, 2 studies showed that placebo benefits were lower when the treated subjects were told that the placebo, presented as an active treatment, cost less. One of these studies had assessed motor and other outcomes in Parkinson disease patients; the other had assessed analgesia in paid, healthy volunteers to whom electric shocks were administered. The implication of the finding that lower treatment cost may diminish treatment gains is that patients who receive generic medicines may have lower expectations and may consequently derive less placebo-related benefit. This could be of concern in psychiatric disorders that are characterized by a large placebo response. Although the 2 "placebo cost" studies cannot be easily generalized to clinical and especially psychiatric contexts, clinicans should consider offering reassurance to patients receiving generic drugs that cost, per se, has no bearing on treatment-related benefit.
Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India candrade@psychiatrist.com.
Chittaranjan
C
Andrade
D003469:Culture; D016527:Drug Costs / Q000706:statistics & numerical data*; D016568:Drugs, Generic / Q000191:economics* / Q000627:therapeutic use*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000191:economics* / Q000523:psychology; D017060:Patient Satisfaction; D015990:Placebo Effect; D011619:Psychotropic Drugs / Q000191:economics* / Q000627:therapeutic use*; D016896:Treatment Outcome
D016568:Drugs, Generic; D011619:Psychotropic Drugs