Beating The Placebo Effect: Red Pill or Blue?

Placebo pills routinely beat Big Pharma medications in clinical trials. As more drugs fail to make the cut due to increased “placebo effects,” what does this say about the inner workings of the human brain and what does any of this have to do with marketing?

Since 1962, double blind testing with placebos has been the norm for medications wishing to pass muster from the US Federal Drug Administration (FDA). However, over the years the placebo effect has been more pronounced with fewer drugs passing clinical trials. To be sure, unusually high responses to placebos have been blamed on ineffective compounds, but there might be other causes at work.

A Wired Magazine titled, “Placebos Are Getting More Effective. Drugmakers Desperate to Know Why” cites some of the challenges facing Big Pharma. Over the years, drug makers have diligently worked to uncover why—for some patients—the act of taking a placebo works as good (or sometimes better) than a promising compound. In fact, according to the article, researchers are discovering, “the body’s response to certain types of medications is in constant flux, affected by expectations of treatment, conditioning, beliefs and social cues.”

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Placebo pills routinely beat Big Pharma medications in clinical trials. As more drugs fail to make the cut due to increased “placebo effects,” what does this say about the inner workings of the human brain and what does any of this have to do with marketing?

Since 1962, double blind testing with placebos has been the norm for medications wishing to pass muster from the US Federal Drug Administration (FDA). However, over the years the placebo effect has been more pronounced with fewer drugs passing clinical trials. To be sure, unusually high responses to placebos have been blamed on ineffective compounds, but there might be other causes at work.

A Wired Magazine titled, “Placebos Are Getting More Effective. Drugmakers Desperate to Know Why” cites some of the challenges facing Big Pharma. Over the years, drug makers have diligently worked to uncover why—for some patients—the act of taking a placebo works as good (or sometimes better) than a promising compound. In fact, according to the article, researchers are discovering, “the body’s response to certain types of medications is in constant flux, affected by expectations of treatment, conditioning, beliefs and social cues.”

For example, for some patients the simple act of watching another person gain relief from a medication sets “expectations” that the medication will indeed provide relief. And since consumers have been bombarded with billions of dollars in drug advertising over the years, Big Pharma has also increased expectations that simply taking a pill will solve a patient’s ills. In addition, a kind and empathetic doctor can also boost the placebo effect.

To help remove the noise from the above variables, drug makers have taken to testing medications in countries across the globe. However, clinical researchers are discovering that even this isn’t a perfect solution as doctors are “paid to fill up trial rosters quickly, which may motivate them to recruit patients with milder forms of an illness.”

Part of the challenge for drug makers is defining the illness in question. The Wired article notes that many new drugs today target “higher cortical centers that generate beliefs and expectations, interpret social cues and anticipate rewards.” Defining “depression” in a patient is often difficult enough, but then try and see if that same definition holds for patients in different countries and communities! It’s tough stuff.

In a sign that the white surrender flag has been waved, drug makers have now all but acknowledged the benefits of placebos. What they’re looking for now is, “the best placebo response plus the best drug response.”

A key lesson from this article is that the human brain is very powerful and scientists don’t quite yet understand exactly how it works. Why or how does the human body improve its condition from the simple act of taking a medication (placebo or not)? Why do patients improve their conditions of depression when a doctor—knowingly—prescribes them a dose of medication that’s too low to be effective?

Another interesting discussion avenue is how customer expectations can be defined and created. For example, the Wired article mentions that drug makers have long known that simply coloring pills can help create expectations of efficacy. Yellow pills may create “doses of sunshine”; red pills let patients know they have potency, and green pills help reduce anxiety. Pills stamped with a brand name also offer a patient assurance and comfort.

Helping our companies understand, create and manage customer expectations is where the marketing function can add significant business value. But as Stan Lee of Marvel Comics fame reminds us, “With great power comes great responsibility!” Marketers must be willing to resist the urge to manipulate customer expectations in an unethical and immoral manner—especially if our products and services are no better than a comparable “do nothing” placebo.

Questions:

• In recent tests, durable warhorse drugs like Prozac have been beat by placebos. If you worked for Big Pharma, how might you suggest that your company “test out” consumer expectations—to see if your drugs actually worked?
• It would be difficult to argue that consumer expectations haven’t increased over the past ten to twenty years. What is a good strategy to manage expectations – keep them low and over deliver?
• Does experimentation with control groups have a place in your marketing function? If so, how? What are you learning?