The Power of the Placebo Effect

Sugar Pills WorkI've been fascinated by the placebo effect ever since I first learned about it in seventh grade Health class.  Everyone knows what the placebo effect IS, but did you know that it can be up to 60%?  A placebo effect rate of 60% means that the placebo worked for 60% of the people who were given it.  Isn't that incredible?

Wired has a fascinating article about the placebo effect, and about how it seems to be increasing.  It's a pretty good article, although I literally laughed out loud at the line, "more financial woes for the beleaguered pharmaceutical industry."  Oh noes, the poor pharmaceutical industry!  I'm sorry, big guy, here, let's have a bake sale!  I was prepared for Big Pharma apologia, and I was not entirely disappointed.  I suspect the author may have skewed his article "friendly" because of his level of access to pharmaceutical insiders, either for the article or for his long term writing career or both.

At any rate, the placebo effect is a big deal to pharmaceutical companies.  As the author points out, "Today, to win FDA approval, a new medication must beat placebo in at least two authenticated trials."  (This is a good rule, by the way.  And keep it in mind the next time someone starts extolling the virtues of magnets or colloidal silver or homeopathy.  Which utterly fails to beat placebo in any test, even one administered at a grade school science fair.)

Unfortunately, drug companies are finding that fewer and fewer of their medications are passing the placebo test.  This turns out to be the result of two things: the pharmaceutical companies are going after different drugs, and cultural expectations - which in America are managed by the drug companies' own advertising campaigns.

Life was easy for the drug companies in the early days.  They had simple, clear cut diseases to go after.  Hypertension, diabetes, asthma, bacterial infection - all of these diseases respond very well to treatment.  But once the drug companies had medicated all the easy stuff, what was left?

Unfortunately for them, what was left was the fuzzier stuff.  Social anxiety, mild depression, PMDD - cognitive issues, things which are both complicated to source and solve, and which tend to respond very well to placebo treatment.  (By the way, when I say that "depression responds well to placebo," I am NOT saying "depression is all in your head."  Pain responds well to placebo, too, but if you've been shot in the leg, that pain isn't "all in your head," either.)

The placebo effect is all about the user's expectations, and in America in the year 2009, our expectation is that we will see prescription ads everywhere.  They clutter our magazines and fill our airwaves, to the tune of $5 billion a year.  Unsurprisingly, advertising works, and the better it works, the more we believe in the power of a pill to cure what ails us.  And the better we believe in the power of a pill, the better that pill will work - whether it contains actual medicine, or just powdered milk.