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Benefits of placebo

I read with interest Jeanette Stafford’s letter on placebos and homoeopathy (PJ, 8 March 2014, p262).

The “Horizon” programme on the placebo effect indicated to me that the medicines licensing authorities and health professional bodies have difficult questions to answer.

I am not holding my breath in expectation of any reaction from these bodies but any response to the questions below would be a helpful start.

The key finding publicised by the television programme was that patients who were made aware that they were receiving a placebo had benefits to the same significant extent as those who were not informed of that fact by the prescriber.

Medicines licensing authorities all demand clinical evidence for effectiveness to be proved using randomised clinical trial data. Is this possible using placebos of different constitutions since it appears that any product labelled “placebo” may be effective in the hands of practitioners?

If a prescriber chooses a placebo and this is accepted by the patient should he or she be able to prescribe it without being accused of professional misconduct? Will pharmacists as dispensers of these placebos be paid for the prescription by the authorities? Should such preparations and products be registered or classified as medicinal?

What do the regulators propose to do about this intriguing situation? Can they continue ignoring the existence of the health benefits of placebos?

Homoeopathy is currently recognised as a licensed system of treatment. It is the tip of the placebo iceberg. Could it be used as a model to embrace all the other treatments that are currently dismissed as placebos and of no benefit because they do not meet the scientific evidence criteria demanded of and designed for pharmaceuticals ­and mainstream medical treatments?

There must be a way forward — safety and cost advantages of placebos are undeniable.


Robert Woodward

Hampshire

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11136846

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