Is the placebo effect becoming stronger?
Firstly, what is the placebo effect? It can be traced to a lie told by an Army nurse during World War II as Allied forces stormed the beaches of southern Italy. The nurse was assisting an anesthetist named Henry Beecher, who was tending to US troops under heavy German bombardment. When the morphine supply ran low, the nurse assured a wounded soldier that he was getting a shot of potent painkiller, though her syringe contained only salt water. Amazingly, the bogus injection relieved the soldier’s agony and prevented the onset of shock. Since then, in clinical trials, patients are either given a real drug or a placebo. The clinicians are unaware which they are giving the patient, and the effect of each is noted.
In recent years many clinical trials have been halted when it has become apparent that the placebo has proven to be nearly as effective as the drug under trial. In the USA, from 2001 to 2006, the percentage of new products cut from development after Phase II clinical trials, when drugs are first tested against placebo, rose by 20 percent. The failure rate in more extensive Phase III trials increased by 11 percent, mainly due to surprisingly poor showings against placebo. The US Food and Drug Administration approved only 19 first-of-their-kind remedies in 2007—the fewest since 1983—and just 24 in 2008. Half of all drugs that fail in late-stage trials drop out of the pipeline due to their inability to beat sugar pills.
It would be fair to say that the effect of the sugar pill has thrown the pharmaceutical industry in to crisis. Scientists are attempting to ascertain why the placebo effect appears to be so strong. Doctors know that some patients really do seem to get healthier for reasons that have more to do with a doctor’s empathy than with the contents of a pill. Initial research looked at data gathered from trials over several decades and found that the geographic location of the trial was one factor. This makes sense in light of discoveries that the placebo response is highly sensitive to cultural differences.
Drug trials are also trying to find drug virgins – patients who have never been treated for particular conditions before. This has pushed trials in to developing nations. Trials have moved aggressively into Africa, India, China, and the former Soviet Union.
Whilst the full aspects of the placebo effect remain unclear, initial findings reveal how powerful the brain really is. The placebo response doesn’t care if the cause of healing is a breakthrough in pharmacology, a compassionate doctor, or a syringe of salt water. All that is required is a belief by the patient that they stand a reasonable chance of getting better.