Placebo effect of medication cost in Parkinson disease

Espay, Alberto J.; Norris, Matthew M.; Eliassen, James C.; Dwivedi, Alok; Smith, Matthew; Banks, Christi; Allendorfer, Jane B.; Lang, Anthony E.; Fleck, David E.; Linke, Michael J.; Szaflarski, Jerzy P.

doi:10.1212/wnl.0000000000001282

Cited by 119 publications

(92 citation statements)

References 34 publications

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“…While studies have reported a significant placebo response in adult patients (such as those with Parkinson's Disease [293]), placebo response rates are particularly high among children and adolescents in a subset of disorders, including psychiatric (anxiety, major depression, and obsessive compulsive and attention deficit disorders), medical (asthma), and painful (migraine, gastrointestinal) conditions [294,295]. As the current RCTs of CBD primarily target children with severe epilepsy, this may be an important issue.…”

Section: Placebo Effectmentioning

confidence: 99%

Cannabinoids and Epilepsy

et al. 2015

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Cannabis has been used for centuries to treat seizures. Recent anecdotal reports, accumulating animal model data, and mechanistic insights have raised interest in cannabisbased antiepileptic therapies. In this study, we review current understanding of the endocannabinoid system, characterize the pro-and anticonvulsive effects of cannabinoids [e.g., Δ9-tetrahydrocannabinol and cannabidiol (CBD)], and highlight scientific evidence from pre-clinical and clinical trials of cannabinoids in epilepsy. These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures. Finally, we discuss results from a new multicenter, open-label study using CBD in a population with treatment-resistant epilepsy. In all, we seek to evaluate our current understanding of cannabinoids in epilepsy and guide future basic science and clinical studies.

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Section: Placebo Effectmentioning

confidence: 99%

Cannabinoids and Epilepsy

et al. 2015

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“…Both of the "placebo cost" studies 5,6 found that placebo was more effective when its stated cost was higher. Perhaps greater expectations, generated by higher costs, mediate a greater placebo response.…”

Section: Critical Appraisal and Clinical Importancementioning

confidence: 99%

“…7 Some points, however, merit consideration. The most important point is that both of the "placebo cost" studies reviewed 5,6 were single-dose studies. There is no evidence to suggest that treatment cost will continue to influence treatment outcomes across weeks, months, or years of treatment, as is necessary in most psychiatric conditions.…”

Section: Clinical Pointsmentioning

confidence: 99%

“…Therefore, limitations notwithstanding, both studies 5,6 remind clinicians that patient expectations are important and that treatment cost can, perhaps, influence treatment expectations and thereby treatment outcomes. Clinicians who prescribe generic drugs should therefore reassure patients that lower cost does not imply lower potency.…”

Section: Clinical Pointsmentioning

confidence: 99%

“…For those who are interested, ethical issues related to the Parkinson disease "placebo cost" study 5 were discussed by the authors of the study 5 as well as in an accompanying editorial. 8 …”

Section: Parting Notesmentioning

confidence: 99%

See 2 more Smart Citations

Cost of Treatment as a Placebo Effect in Psychopharmacology: Importance in the Context of Generic Drugs

Andrade¹

2015

J. Clin. Psychiatry

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Estimation of Potential Savings Through Therapeutic Substitution

Johansen

Richardson

2016

JAMA Intern Med

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IMPORTANCE Therapeutic substitution offers potential to decrease pharmaceutical expenditures and potentially improve the efficiency of the health care system. OBJECTIVE To estimate potential savings through therapeutic substitution in terms of both overall and out-of-pocket expenditures of branded drugs when a generic in the same class with the same indication was available. DESIGN, SETTING, AND PARTICIPANTS Repeated cross-sectional study using the 107 132 individuals included in the nationally representative Medical Expenditure Panel Survey (2010-2012) along with their reported prescribed medicine use. The Orange Book, company financial statements, US Food and Drug Administration records, and published research were used for adjunctive information. MAIN OUTCOMES AND MEASURES Estimated excess expenditure due to branded drug overuse when a lower-cost generic in the same class with the same indication was available. RESULTS The study included 107 132 individuals between 2010 and 2012, of whom 62.1% (95% CI, 61.4%-62.8%) reported use of any prescribed medicine. A total of 31.5% (95% CI, 30.7%-32.2%) used a medication from an included drug class, whereas 16.6% (95% CI, 16.0%-17.1%) of the population used a branded drug from the included classes compared with 24.0% (95% CI, 23.4%-24.7%) who used a generic and 9.1% (95% CI, 8.7%-9.4%) who used both. In the included drug classes, the majority of the drugs were generics, with a total of 93.5 billion standardized doses compared with 47.4 billion standardized doses of branded drugs.

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Placebo effect of medication cost in Parkinson disease

Abstract: This study provides Class III evidence that perception of cost is capable of influencing motor function and brain activation in Parkinson disease.

Cited by 119 publications

References 34 publications

Cannabinoids and Epilepsy

Cannabinoids and Epilepsy

Cost of Treatment as a Placebo Effect in Psychopharmacology: Importance in the Context of Generic Drugs

Estimation of Potential Savings Through Therapeutic Substitution

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