It is a well known fact in Medical Research that dummy pills which are used in clinical trials provide surprising results often equaling relief provided by actual drugs. This is known in the medical parlance as placebo effect. It is often used in persons with Parkinson Disease. Parkinson Disease is a degenerative brain disorder characterized by tremors, stiffness and balance problems. A 2008 meta-analysis found that placebos used in clinical trials of Parkinson’s treatments improved symptoms by an average of 16%.

Patients suffering from Parkinson’s disease were treated with placebo instead of regular medication were found to perform better when they were informed that they were treated with an expensive drug which was in fact a placebo.

The research revealed that the well documented and studied ‘Placebo Effect” which is real relief effected by a sham treatment or medication can be further enhanced by adding information about the cost of the treatment. This is for the first time that a trial about a concept has been demonstrated using subjects with real illness; in this case it was Parkinson’s, a progressive neurological disease that has no permanent cure.

“The potentially large benefit of placebo, with or without price manipulations, is waiting to be untapped for patients with [Parkinson’s disease], as well as those with other neurologic and medical diseases,” the authors wrote in a study published online Wednesday in the journal Neurology.

However the study has opened a Pandora box of ethical questions about violation of trust involved in between a doctor–patient relationship.

A simple saline solution was used for treating Parkinson Disease but the real catch was, the patients were told the treatment cost $100 per dose or for even better results, tell them the treatment costs $1500. In fact researchers from the University of Cincinnati in an unusual clinical trial pitted two placebo drugs with one another. The only difference between the two placebo treatments was its price.

12 patients with “moderately advanced” Parkinson’s and asked them to participate in a clinical trial of a medication described as “a new injectable dopamine agonist.” The volunteers were told that they will be receiving two different types of injectables, the only difference was one drug was 15 times more expensive than its counterpart. Both the injectable were actually placebo. The result was surprising- the subjects perceived that the more expensive drug was more effective than its cheaper counterpart.

A pair of neurologists wrote an editorial that accompanied the study “Patients’ expectations have an important role in the efficacy of medical therapies. Placebo can be the physician’s friend. The outcome of this study … opens our eyes to another nuance of placebo effect.”

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