How well does your medication work?


#1

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#2

Maggie, stories like this show what an anti-American socialist you are. These businesses provide a steady income to people with kids who need braces and piano lessons. The customers feel a little bit better from their med or placebo… whatever… which is extra effective because of the real side effects and the high price paid for brand name medication. Grandparents who invested in the drug company get to have a happy retirement off of the well earned profits. What is not to like about our current arrangement, why would you want to strangle this basket of sleeping kittens by passing on this story?!


#3

Every time I see “sugar pills” specifically for placebos, I wonder: do they use sugar pills as placebos for oral diabetes meds?


#4

We can do this (and all other sorts of labeling) “bottom-up”. Without having to ask for permissions and even without having to fight. (I love winning without fight.)

We got smartphones. We got internet databases. The boxes already got machine-readable fields (the barcodes). All we need is coupling this together and making an API for the database queries.

If the API is of generic enough nature, so the apps are not covered by the FDA or other rulemakers for providing information, and the database itself (several databases for different purposes) can be moved around between jurisdictions or even to p2p “cloud” (crypto-sign the data to maintain authenticity!), the Powers That Be cannot stop it even if they would try.

Smartphones now, wearable augmented-reality displays tomorrow.


#5

Wow, what a first post! It sounds as if the poster expects that all drugs will be perfectly safe, 100% effective and come free of cost. (Paradoxically, it’s a measure of the effectiveness of modern medicine that people actually expect it to work - and work better than it does. For most of human history, placebo was all that doctors had to offer.)

And there’s a bit of a supposition - not in Maggie’s post, nor in the article, but in the reply - that somehow the drug developers are keeping this information secret. The information on safety and efficacy is anything but secret: it’s disclosed in all the prescriber literature. The proposal is about making it more accessible to the patient - and I’m all for it. There’s a lot of regulation that governs today’s presentation: the companies have to follow a rigid format laid down by the FDA. That’s why it’s actually impossible for drug companies to take unilateral action about this.


#6

Several years ago I suffered several months of severe depression, a friend pushed hard for me to start taking antidepressants. Being the creative type I resisted; I thought the depression might provide artistic inspiration, and the drugs would numb my creativity. He condescendingly treated me like an idiot for not taking the drugs, and yet the depression eventually passed without using drugs. I’m sure if I had taken antidepressants he would be saying “see? they worked!”, and yet researchers have now found they have a statistically insignificant improvement over placebos.


#7

Of course, the neat thing is a placebo is significantly more effective than nothing at all. However, if you realize you’re taking a placebo, then it’s not going to work.

Hence publicizing the results might well make these medicines (that are currently providing some medical benefit through the placebo effect) less effective, reducing over-all patient wellness.


#8

The snark is strong in this one!

– Darth Hater


#9

There are some studies that show that even if you know it’s a placebo, significant placebo effects can still occur. Interestingly, in the linked article (just the first googled result…) the doctor told the patients that the pill could make them feel better via the placebo effect…


#10

I really liked the sample shown for Lunesta. As a former technical writer, I thought the ideas were both clearly and accurately presented. I liked it much better than the current Drug Facts labels or the pages and pages of information I get from my pharmacist or in the box of medicine.


#11

That’s actually not true. The placebo effect can work even if you know you are taking a placebo. And many things are part of the placebo effect, not just the "pill"or what not. Just consulting a caring doctor is part of the placebo effect - a big part, in fact, and one of the placebo effects that makes alternative medicine seem effective. And that effect works even if you know about it. There is a lot of nuance to placebo effect, which is on of the reasons I’m not sure it can be easily summarized on a pill package, though I like the idea given how many medications barely work better than placebo. However, to be fair, this rule would have to be applied to all allt med pills, too.


#12

It was snark, but when I was a paramedic I saw the attractive blonde EMTs(basic) farmed by the drug reps pretty quickly, these women had a proven basic understanding of medicine and the looks. The were sent into doctors offices in short skirts and high heels to remind doctors to only prescribe the brand name meds instead of effective or even more suitable generics. Placebos are fine, I suppose, when handed out by the shaman in exchange for a chicken but considering side effects a sugar pill might be safer than high priced on-pantent brand name drugs.
I am a socialist when it comes to social welfare so I expect society to invest in medical research at an appropriate level and to provide appropriate care to all members of society including appropriate and effective medications when warranted without consideration for profitability of industries surrounding this basic human societal obligation.


#13

Thanks HMSGoose and Skeptic - your point (especially about it not just being the pill) is very much worth noting.


#14

I was going to say something about the fact if you know ahead of time you are basically taking something that won’t have a medical reason for working then it won’t work, but something kept nagging me not to.

While looking at the other comments it kind of came to me. I have a friend that cuts lenses for prescription glasses, and he has seen on more than one occasion where someone will present a broken lens to an optometrist in a very specific way so the broken edge is facing up. He inquired about it and was basically told that some people believe that there is a liquid in the glass that helps them see better and they are trying to keep as much of it in there as possible. Now to my rational science oriented mind I was all like, “whuuuuut?”, but it kind of made sense in a way. I’ve talked with people who have no idea how electricity works other than I flip a switch and it comes on or how light works, and the list can go on and on. So I can see how for a lot of people just being told by a doctor, here is a pill that is not medicine, but it might make you feel better would have a positive benefit simply because it was being told to them by a doctor.


#15

I knew you’d get at least one ‘whooooosh’ with that comment :wink:


#16

Can we have all of the homeopathic “remedies” clearly called out for actually being placebos?


#17

I can see a doctors desire to give the patient more information and not be handed the legal and moral hot potato of being the only one informed about a pharmaceutical.

I would be interested to know exactly what the placebos are. Maybe it’s there somewhere in the fine print (squinting). Can we be sure the placebo is not a lowered dose of the substance under test?

Perhaps all the desire I see in the comments to debunk non pharmaceutical treatment is to give more faith to pharmaceuticals. This faith would certainly increase the placebo effect.

I have seen enough pharmaceuticals go horribly wrong on myself, relatives, and friends that nothing extra on the package is going to make me trust them any more. They for me are the alternative treatment option.


#18

Interesting question. I’ve heard one explanation of how a doc could possibly prescribe a placebo with informed consent: “I’d like to prescribe some medicine for you. Nobody understands how this medicine works, and in fact, chemistry suggests that it ought to do nothing at all. But studies show that it works in a lot of patients. In any case, there’s very little risk of harmful side effects. Care to give it a try?”


#19

Very nice!

I like the fuzziness of the phrase “a lot” in [quote]… it works in a lot of patients.[/quote] and of the phrase “very little” in [quote]…there’s very little risk of harmful side effects.[/quote]

For the patient who wants a magic pill from the doctor, and is not inclined to research the name of the drug they’ve been prescribed, this is an honest endorsement. Even for those who are not so credulous, it’s not necessarily a show stopper, as noted by Skeptic about 8 posts upthread, and HMSGoose about 10 posts upthread.

To be ethically correct, the cost should be nominal, and all profits from the sale of placebos should be folded back in to medical research.


#20

For a “treatment” to be called “placebo” it needs to be a “simulated or otherwise medically ineffectual treatment” which precludes it being simply a lowered does of a known medication.

But as noted severally in this thread, as well as the linked article, the placebo effect is complex and robust.

My complaint with homeopathic remedies is the magical-thinking nature of their preparation. When these things are sold as medicine, without the disclaimer that there is no rational, empirical, scientific basis for their effectiveness, someone is engaging in fraud, because not a single atom of the active ingredient is available in the “medication.”