Why the next blockbuster may be no drug at all

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Make mine a sugar pill!
Make mine a sugar pill!

Biotech brand managers—how would you market placebo?

A surprising treatment regimen is showing great promise and generating buzz in biotech and big pharma. It works for several debilitating diseases, costs next to nothing and, best of all, has no adverse events.

What is this new drug and how can you get in on the launch team? It's that stalwart star of many a study arm, good old placebo.

Dueling with placebo

Have you ever watched market research for a blood pressure medication, a pain reliever, an asthma drug or an antidepressant?

Physicians behind the one-way mirror may look at the efficacy results and express their amazement, not necessarily at improvements with the study drug, but at how well placebo performed.

How is it possible that an approved, proven, expensive branded drug can be shown up by a sugar pill?  

The power of nothing

Writing in The New Yorker, Michael Specter describes changing attitudes about the placebo effect and the role it may have in medical practice.

This isn't just New Age stuff; a recently formed institute at Harvard, The Program in Placebo Studies and the Therapeutic Encounter, is dedicated to the interdisciplinary study of placebo and “medical ritual, the patient-provider relationship, cultural context, and the power of imagination, trust and hope in the healing process.”

In other words, what really makes a patient get better? It's a tricky question.

Placebo cred at Harvard

The Placebo Studies Institute would conceivably have been laughed off campus as recently as 20 years ago.

But neuroimaging techniques that allow researchers to track a patient's response to a drug have shown, for example, that saline can reduce symptoms of Parkinson's and help patients produce more dopamine.

The key is for patients to believe the drug is going to work. What they expect is directly related to how they heal.

What would OPDP do?

The placebo effect is complex. Obviously, it doesn't work for everyone, and it can't take the place of proven drug therapies. But pipelines aren't what they used to be. The regulatory approval process has become positively Draconian.

So, imagine the possibilities if you were to lead the placebo launch team and submit to the Office of Prescription Drug Promotion (OPDP).

You'd need unique positioning (“Designed to Deceive”) and a prominent disclaimer (“The mechanism of action is completely unknowable.”)

You'd have plenty of studies to support your claims, but the efficacy story would be a mixed bag. The good news? Placebo needs just one thing to succeed—the patient's belief that it will work. The bad news? Placebo stops working as soon as the patient loses faith.

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