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Healthy Skepticism Library item: 13151

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Waber RL, Shiv B, Carmon Z, Ariely D.
Commercial Features of Placebo and Therapeutic Efficacy
JAMA 2008 Mar 5; 299:(9):1016-1017
http://jama.ama-assn.org/cgi/content/extract/299/9/1016


Abstract:

To the Editor: It is possible that the therapeutic efficacy of medications is affected by commercial features such as lower prices. Because such features influence patients’ expectations,1 they may play an unrecognized therapeutic role by influencing the efficacy of medical therapies, especially in conditions associated with strong placebo responses.2-3 To investigate this possibility, we studied the effect of price on analgesic response to placebo pills…
… Placebo responses to commercial features have many potential clinical implications. For example, they may help explain the popularity of high-cost medical therapies (eg, cyclooxygenase 2 inhibitors) over inexpensive, widely available alternatives (eg, over-the-counter nonsteroidal anti-inflammatory drugs) and why patients switching from branded medications may report that their generic equivalents are less effective. Studies of real-world effectiveness may be more generalizable if they reflect how medications are sold in addition to how they are formulated. Furthermore, clinicians may be able to harness quality cues in beneficial ways,6 for example, by de-emphasizing potentially deleterious commercial factors (eg, low-priced, generic)…

ariely@mit.edu

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963