Research published in August 2015 (Increasing placebo responses over time in U.S. clinical trials of neuropathic pain) and published in the Journal Pain focused on over two decades’ worth of clinical trials – 80 in all. The results showed that, as many have speculated, our placebo response is indeed getting stronger. And, because one measure of a drug’s effectiveness is its ability to perform better than the placebo, more pain-drug trials are failing than in the past. But, interestingly, the researchers found that this increase was only true for studies conducted in the U.S.
A scary story in Salon about overt corporate deception in the marketing (even just the *naming*!) of certain drug products – as in the ‘repackaging’ of Prozac by Eli Lilly to exploit new markets. As in other, non-pharmaceutical marketing, cultural expectations play an enormous role.
‘I suggested to Moerman how odd it is that the meanings we ascribe to a pill can sometimes be more powerful than its active substance, especially in the realm of psychopharmacology.
“Well, James, you’re an anthropologist, right? You know the power of meaning! Every culture has its symbols and objects of veneration and it is no different with us. Once, for us, we revered crosses and statues of the Virgin Mary, but now pills and stethoscopes capture our worship. So even an inert pill can affect us because it has shape and form and a context, and it has language attached. It comes in a blue box or a pink box, it’s taken in a pharmacy, doctor’s room, or hospital with all the panoply of a thousand years of medical tradition behind it to give it overwhelming symbolic weight.”‘
Yet more science on the placebo effect, with a focus on “the impact of the reputation, charisma and convictions of the doctor administering (placebo)”.
“The concept of the self being an autonomous being is a deeply held belief in western civilisation, but we affect each other all the time.”
Following on from the recent post on antidepressants and the placebo effect, we find a website dedicated to sharing information about antidepressant toxicity. It may be that for some people at least, the meds are not only useless but actually harmful. You be the judge! Toxic Antidepressants.
We’ve mentioned elsewhere on this site that conventional doctors are quite aware that they’re often prescribing ‘placebos’ – that is, antibiotics for conditions which they know will not respond to antibiotics. Why? It seems, that’s what patients expect, and doctors, under the pressure of pushing as many through the doors per hour as they can, just don’t have the time to explain that medication is just not necessary for something like a viral infection. At least, we hope that this is the explanation. We’d hate to think that the medical professiona was at all involved in helping bolster drug sales …
Here’s an NPR news article about the over-prescription phenomenon. Problem is, the practice is not only unnecessary and expensive, it can be dangerous.
But while researchers have looked at age, gender and religiosity, among other factors, findings have been inconsistent.
"No one has been successful in identifying a profile of a placebo responder," said one researcher.
If such a group were found, she added, "drug companies would be excluding those people [from clinical trials], so they’d be able to test their drugs more correctly."
"Here’s where it gets crazy … (the incidence of) the placebo effect itself is increasing."
"Approximately half the drugs that fail in late stage trials fail because they simply can’t outperform placebos".
In 2005, global pharmaceutical sales totalled US$602 billion with growth of 7% from the previous year.
At an average annual growth rate of 14% between 1994 and 2003, pharmaceuticals top the OECD manufacturing trade growth stats, ahead of coke, refined petroleum products and nuclear fuel (8%), medical, precision and optical equipment (7.5%), aircraft and spacecraft (7.4%), and motor vehicles, trailers and semi-trailers (7.3%).
In 2006 the 10 largest pharmaceuticals firms accounted for 46 per cent of global sales.
Ref. Medicines Australia
An interesting talk on the Australian Broadcasting Commission ‘Ockhams’Razor’ radio program about the marketing of (legal) drugs by big pharma through the medical establishment. The speaker is Professor Christopher Norden, from Adelaide Hospital and the Institute of Medical and Veterinary Sciences. He talks of his own experience of the many incentives offered to practitioners by pharmaceutical companies to prescribe their wares.
From Professor Norden’s talk:
"It is about a hundred years since that great Canadian-born physician Sir William Osler, Regius Professor of Medicine in Oxford, complained about the increasing influence of the pharmaceutical industry on the medical profession. If he knew how this influence had increased since then, he would be turning in his grave at the way the industry now dominates doctors’ prescribing habits. It does this not only by direct and indirect pressure on the doctors themselves, but also by encouraging the public to ask for scripts and to demand that governments provide the money."