Service of It Must Be Good: It’s Expensive Part II

February 9th, 2015

Categories: Marketing, Medical Care, Medicine

placebo

The previous post covered wine, this one medical treatment.

What a Pill

“When patients with Parkinson’s disease received an injection described as an effective drug Getting an injectioncosting $1,500 per dose, their motor function improved significantly more than when they got one supposedly costing $100, scientists reported,” wrote Sharon Begley in “Expensive’ placebo beats ‘cheap’ one in Parkinson’s disease” on reuters.com.

“Underlining the power of expectations, the motor improvements, measured by a standard Parkinson’s assessment, occurred even though both injections contained only saline and no active ingredients.

“The research, said an editorial in the journal Neurology, which published it, ‘takes the study of placebo effect to a new dimension.'”

Of the dozen volunteers in the study, observed¬†neurologist Alberto Espay, the greatest improvement happened for the eight who expected the expensive drug to be more effective. The other four, who didn’t anticipate benefits, showed little change, wrote Espay, University of Cincinnati, who led the study.

In your experience, what part of a successful treatment for illness involved the mind and what the medicine? If you pay a lot for a drug, treatment or physician, are you more confident that the results will be positive?

leaving a hospital

 

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6 Responses to “Service of It Must Be Good: It’s Expensive Part II”

  1. JPM Said:

    The point you make is absolutely valid. Curing the sick is as much as question of perception as of pills. A doctor’s manner can often do more good than medicine. They can do what computers cannot, no matter how well programmed.

    I go to one doctor who does not accept insurance. Is he a better doctor because he spends more time with me and listens? I have no way of knowing. However, I do know that, whereas a bunch of other doctors failed to make me feel better, he has succeeded.

    That is why, whether the egalitarians like it or not, there will always be two tier medicine.

  2. Martha Takayama Said:

    The whole issue of outrageously overpriced medication for diseases whether epidemiological or common is fraught with contradictions and corporate mythology!

    Positive expectations and thinking undoubtedly help resistance and recovery to disease. However, it is simply unrealistic to think that positive thinking is a cure for all diseases. The issue of effectiveness of placebos is so mysterious that I don’t know what to think. However there is no reason to think that only name brand, supposedly precious medical treatments that require inordinately high prices to compensate the poor pharmaceutical companies is nonsense.

    The best example of low cost copies of expensive drugs is the Brazilian experience with treatment for AIDS. Long ago it was estimated that the spread and mortality rate for aids would run amok in Brazil because the drugs being developed and marketed at great expense here would not be available or have accessible prices there. The Brazilian government simply set out to simultaneously directly engage the public with realistic public health information and to duplicate in their own laboratories the medicines for treatment. Their success is well noted.

    The whole concept of boutique doctors and medicines seems a misunderstanding of the Hippocratic oath.

  3. Jeanne Byington Said:

    Martha,

    Older people who need drugs are aware of the costs–eventually their insurance runs out–as are those whose insurance companies won’t cover a new and expensive lifesaving medicine. Those with great co-pay situations, who are asked for $10 when they pick up a prescription, generally have no idea and I would guess there are more of them.

    That said, if someone is shooting me with flu or some other vaccine I wouldn’t think the stuff was better or worse if it cost more. I’d ask the doctor if he thought the version I was getting was effective and if I trusted the doctor, would believe what he said.

    I had physical therapy for a shoulder issue and it saved me from an operation. My insurance didn’t cover the fee for each visit and I had to pay $45 over and above. At another time, I went to physical therapy after a broken foot to insure that my balance was as it should be. This therapist accepted my insurance without charging me a supplement. Both were great. I didn’t think that the second one was worse because I didn’t have to pay more–I was grateful!

  4. Jeanne Byington Said:

    JPM,

    Thank goodness for the doctor who doesn’t take insurance as the outcome has been positive. What is scary though is that many can’t afford this option and as bad, should their money run out, those that benefited at one time might no longer. A friend whose parents were extremely comfortable [in his day he was well known in certain NYC circles] died after being cared for by RNs at home for years. They left no inheritance. All their money went to their care.

    I have friends with terrible back issues who keep trying to find a remedy to their pain. I’m sure that they have had expensive and inexpensive treatments in addition to operations in some cases and all they want is relief. They would give anything for it. If a placebo worked, they would welcome it. So far, not much has helped.

  5. Lucrezia Said:

    It would appear that participants in this study think in terms of dollars instead of doctors. Anyone suggest checking on medical reputations, rather than concentrating on costs? Anyone not being concerned that a cost differential between $100 and $1500 sounds suspect? Such a bizarre choice would send me running for the hills, or at least to a trustworthy medic.

    And no, the idea of costly treatment makes me feel anything but better.

  6. Jeanne Byington Said:

    Lucrezia,

    I didn’t see covered in the article if any of the people in the study knew how much the treatments of the others cost so I can’t comment on your [rhetorical] question.

    I imagine if you were having a facelift or other plastic surgery, you’d look to see the results of others and my bet is that the better results cost plenty. As I am a chicken when it comes to such things, I won’t be able to report on this first hand. Scary enough if you need an operation but to volunteer for one….no way!

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