Commercial Features of Placebo and Therapeutic Efficacy

doi:10.1001/jama.299.9.1016

Cited by 323 publications

(80 citation statements)

References 3 publications

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“…Hegerl & Mergl [36] argue that features of daily practice that are not applicable in randomized trials (such as adjustment of dosing, switching of drug and also its pricing [37]) alter the efficacy of drugs in daily routine, as does the level of health insurance a patient has, the status as inpatient or outpatient and the relapse and recurrence history of an individual patient. Furthermore, the clinical equivalent of placebo treatment is what they call 'watchful waiting', which is frequently used by physicians before prescribing a drug, and that does generate less hope (and less of a placebo response) than providing a 50 per cent chance of receiving a drug in a randomized placebo-controlled trial.…”

Section: What Is the Placebo Response Rate In Clinical Routine?mentioning

confidence: 99%

The placebo response in clinical trials: more questions than answers

Enck¹,

Klosterhalfen

Weimer³

et al. 2011

Phil. Trans. R. Soc. B

137

135

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Meta-analyses and re-analyses of trial data have not been able to answer some of the essential questions that would allow prediction of placebo responses in clinical trials. We will confront these questions with current empirical evidence. The most important question asks whether the placebo response rates in the drug arm and in the placebo arm are equal. This 'additive model' is a general assumption in almost all placebo-controlled drug trials but has rarely been tested. Secondly, we would like to address whether the placebo response is a function of the likelihood of receiving drug/placebo. Evidence suggests that the number of study arms in a trial may determine the size of the placebo and the drug response. Thirdly, we ask what the size of the placebo response is in 'comparator' studies with a direct comparison of a (novel) drug against another drug. Metaanalytic and experimental evidence suggests that comparator studies may produce higher placebo response rates when compared with placebo-controlled trials. Finally, we address the placebo response rate outside the laboratory and outside of trials in clinical routine. This question poses a serious challenge whether the drug response in trials can be taken as evidence of drug effects in clinical routine.

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Section: What Is the Placebo Response Rate In Clinical Routine?mentioning

confidence: 99%

The placebo response in clinical trials: more questions than answers

Enck¹,

Klosterhalfen

Weimer³

et al. 2011

Phil. Trans. R. Soc. B

137

135

View full text Add to dashboard Cite

show abstract

“…Nocebo (and placebo) effects engage a complex set of neural circuits in the central nervous system that modulate the perception of touch, pressure, pain and temperature (1, 3, 4). Commercial features of drugs such as price and labeling influence placebos (5, 6). On page 105 of this issue, Tinnermann et al .…”

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confidence: 99%

Nocebo effects can make you feel pain

Colloca

2017

Science

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“…When patients were given a famous pain killer in a branded or unbranded form with either an inert or an active formulation, Aspirin was more effective than placebo, and branded tablets (both active and placebo) were more effective than their unbranded counterparts [24] . Another study found that patients who were told their pills were more expensive (USD$2.50) had more symptomatic relief than those who were told their pills cost just 10 cents [25] . The placebo response may also be observed by increasing expectations about an intervention.…”

Section: Evidence Of Placebo Responsementioning

confidence: 99%

Placebo effect in osteoarthritis: Why not use it to our advantage?

Campos¹

2015

WJO

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Osteoarthritis is a major cause of pain and reduced quality of life in the elderly, as well as a major economic burden. Unfortunately, there is no currently effective therapeutic strategy to prevent the progression of Osteoarthritis, and its treatment poses a great challenge to the medical community. Most of the treatment modalities currently available for osteoarthritis have small to moderate effect sizes, according to main metaanalyses and treatment guidelines. On the other hand, literature has demonstrated that placebo is considerably effective. The present article discusses the history of placebo effect and its scientific evidence, comments on ethical issues and provides insights about how it may be used to our advantage when treating osteoarthritic patients. Core tip: Osteoarthritis is a major cause of pain and reduced quality of life in the elderly population, as well as an economic burden. Unfortunately, there is no currently effective treatment, and most of them show small to moderate effect sizes, according to main meta-analyses. On the other hand, literature has demonstrated that placebo has a considerable effect size in osteoarthritis clinical trials. So why not use it to our advantage?de Campos GC. Placebo effect in osteoarthritis: Why not use it to our advantage? World J Orthop 2015; 6(5): 416-420 Available from:

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Commercial Features of Placebo and Therapeutic Efficacy

Cited by 323 publications

References 3 publications

The placebo response in clinical trials: more questions than answers

The placebo response in clinical trials: more questions than answers

Nocebo effects can make you feel pain

Placebo effect in osteoarthritis: Why not use it to our advantage?

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