Archive for Wednesday, March 5, 2008

The price you pay for pain relief

March 5, 2008

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How do you spell relief? P-A-Y ... M-O-R-E.

In a study published today in the Journal of the American Medical Association, researchers found that people given identical pills received greater pain relief from the one they were told cost $2.50 than from one supposedly costing 10 cents.

"We all know that we expect more from products with high prices and good names, and we wanted to see if these things could change how we react to pain medication," said Massachusetts Institute of Technology behavioral economist Dan Ariely, who led the research. "The answer seems to be yes."

Ariely said the findings might help explain why many people report that generic drugs are less effective than their branded equivalents and why a substantial number of patients prefer such costly pain relievers as Celebrex to cheap alternatives like aspirin.

Previous studies have shown that price has a powerful impact on the psychology of consumers.

Researchers at the California Institute of Technology reported in January that expensive wine was more pleasant-tasting than identical wine that cost less. In an earlier experiment, Ariely found that people given inexpensive energy drinks felt more tired and worked out less than those who received identical energy drinks that cost more.

In the latest study, which was funded by MIT, 82 volunteers were asked to rate the intensity of electric shocks administered to their wrists, before and after they received a dummy pain pill.

Tests subjects did not know they received a placebo. Rather, they were told the pill was a new opioid painkiller similar to codeine but faster-acting. Each participant received a colorful brochure touting the drug as "an exciting new medication" that could provide "up to 8 hours" of pain relief.

Placebos have been shown to alleviate mild to modest pain; scientists believe the anticipation of pain relief triggers the release of endorphins - opiate-like substances produced by the body.

Ariely and colleagues wanted to see whether price - a signal of quality - could amplify or reduce the placebo effect.

Half of the study participants were told that the drug had a regular price of $2.50 a pill. The remaining subjects were told that the new medication had been discounted to 10 cents a pill. No explanation was given for the price cut.

Eighty-five percent of subjects who received regular-priced pills reported feeling less pain after taking the dummy medication, compared with 61 percent of those who received the discounted pills, researchers said.

Ariely said enthusiasm on the part of physicians about the lower-priced medications they prescribe might counteract patients' negative feelings - and improve the efficacy of the drugs. But the idea needs to be tested, he said.

"How do we give people a cheaper medication, or a generic, without them thinking it won't work?" he said.

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