WIRED's feature on the increasing effectiveness of placebo drugs -- those tablets of inert sugar designed to present a baseline measurement for an actual drug being tested -- is fascinating for a number of reasons.
It's an interesting story, and well-told. It's educational and interesting. And it raises lots of questions.
Foremost among them: Why are placebo drugs beginning to test as equally effective as the real drugs being given patients? Are the actual drugs under development simply less effective, or is something going on with our collective psyche that's strengthening the placebo effect?
Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 1980s. One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time.
It's not that the old meds are getting weaker, drug developers say. It's as if the placebo effect is somehow getting stronger.
The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today's economy, the fate of a long-established company can hang on the outcome of a handful of tests. Why are inert pills suddenly overwhelming promising new drugs and established medicines alike? The reasons are only just beginning to be understood. A network of independent researchers is doggedly uncovering the inner workings—and potential therapeutic applications—of the placebo effect. At the same time, drugmakers are realizing they need to fully understand the mechanisms behind it so they can design trials that differentiate more clearly between the beneficial effects of their products and the body's innate ability to heal itself.
A special task force of the Foundation for the National Institutes of Health is seeking to stem the crisis by quietly undertaking one of the most ambitious data-sharing efforts in the history of the drug industry. After decades in the jungles of fringe science, the placebo effect has become the elephant in the boardroom.
Too bad the drug companies want to harness the power of the placebo effect to sell more drugs, rather than strengthen our ability to improve our health without them.
