Price Plays Part in Perceived Power of Medication

TUESDAY, March 4 (HealthDay News) -- When people think that a medication is expensive, they tend to report more benefit than when they think the drug is cheap, a new study finds.

In fact, 85 percent of people given what they thought was an expensive painkiller said they had reduction in pain, compared with 61 percent of those given the same pill, which they were told was cheap. Most surprisingly, both were the same placebo pill.

"When we gave people medication, a pain placebo, which was discounted, it was less effective," said lead researcher Dan Ariely, a behavioral economist and visiting professor of marketing at Duke University, and author ofPredictably Irrational: The Hidden Forces That Shape Our Decisions.

A placebo works on the power of expectations, Ariely explained. "When people doubt the efficacy, the efficacy goes down, in this case because of a discount," he said. "The interesting thing is that marketing variables that have nothing to do with the medication modulate expectation, and therefore can modulate the efficacy of medication."

The report is in the March 5 issue of theJournal of the American Medical Association.

In the study, Ariely's team gave 82 people a light electric shock to measure their perception of pain. This test was given before and after the individuals were given what they were told was a pain pill.

Half the people were given a brochure that described a new painkiller that cost $2.50 a dose. The remaining individuals were given a brochure that described the pill as having been marked down to 10 cents.

The researchers found that among those who thought the pill cost $2.50, 85 percent reported having pain relief. However, for those given the 10-cent pill, only 61 percent reported any pain relief.

"When you expect to get something on discount, and you expected it to be worse, it can actually be worse," Ariely said.

An important implication of this study is how does one present discounted drugs to patients without them thinking they are inferior, Ariely said. "How do we give discounted drugs to people we want to give discounted drugs without giving them the negative side effects?" he asked.

The problem is having people understand the price of the drug is not a function of the effectiveness of the drug. Ariely wonders if discounted drugs and small co-pays give people the impression that the drugs are of lower quality.

One way of reducing the effect of cost on the perception of efficacy is when patients understandwhythey are getting the discounts they are getting, Ariely said. Another strategy is for doctors to explain to their patients the benefits of the drug and that cost is not related to the performance of the drug.