With a price tag like that, you know it’s what’s best

Would you pay more for name-brand headache medicine than the generic or store brand?  If your budget is like mine, probably not; after all, the tablets are the same, it’s just the packaging that’s different.

But on the flip side, what if your favorite practitioner recommends an expensive treatment that will help you or your loved one recover from a chronic condition? Not surprisingly, treatments with higher price tags make patients feel better, even when there are not any differences in the treatments, nor even when the treatments are just placebos!  Per research by Waber et al., (“Commercial Features of Placebo and Therapeutic Efficacy”)

These results are consistent with described phenomena of commercial variables affecting quality expectations and expectations influencing therapeutic efficacy. Placebo responses to commercial features have many potential clinical implications. For example, they may help explain the popularity of high-cost medical therapies (eg, cyclooxygenase 2 inhibitors) over inexpensive, widely available alternatives (eg, over-the-counter nonsteroidal anti-inflammatory drugs) and why patients switching from branded medications may report that their generic equivalents are less effective.

In other words, patients perceive more expensive treatment as being more effective.  This is in many parts “research as confirmation of what we already know”, also known as “A Duh! Study”.  (Which is why it was in the 2008 Ig Nobel Awards.)  However, this preference for expensive treatments can also be a post-purchase rationalization, where we have the unconscious tendency to rationalize why the things we have paid for were such good choices.

Human beings are subject to a large number of cognitive fallacies and biases of judgment.  We unconsciously deceive ourselves in a number of ways, which is why scientists must use randomized, double-blinded, and repeatable studies with falsifiable hypotheses. (The word “falsifiable” is somewhat confusing or misleading; it simply means that the hypotheses can be proven wrong, which is statistically safer than trying to prove them correct.)

Our brains love to find patterns — that’s how we make sense of all the sensory input we’re bombarded with — but we will also see patterns even when they don’t exist.  Even the most earnestly objective researcher can misinterpret incomplete data, or give more attention to data that supports their hypothesis than that which doesn’t.  This is why double-blinded studies are important, so neither the study subjects nor the data gatherers know who is in the treatment or the control groups.

Naturally, shysters will take advantage of people by Read the rest of this entry »