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Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect

Background: Recent research shows that placebo mechanisms can be utilized in ethical and legal ways such as in open-label conditions, when patients know that they receive placebos, and through psychological interventions aiming to optimize patients’ expectations. Showing that placebo interventions a...

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Autores principales: Hamberger, Jens, Meissner, Karin, Hinterberger, Thilo, Loew, Thomas, Weimer, Katja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751772/
https://www.ncbi.nlm.nih.gov/pubmed/31572237
http://dx.doi.org/10.3389/fpsyt.2019.00653
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author Hamberger, Jens
Meissner, Karin
Hinterberger, Thilo
Loew, Thomas
Weimer, Katja
author_facet Hamberger, Jens
Meissner, Karin
Hinterberger, Thilo
Loew, Thomas
Weimer, Katja
author_sort Hamberger, Jens
collection PubMed
description Background: Recent research shows that placebo mechanisms can be utilized in ethical and legal ways such as in open-label conditions, when patients know that they receive placebos, and through psychological interventions aiming to optimize patients’ expectations. Showing that placebo interventions are also cost-efficient could improve their acceptability. Objective: To review studies that performed health economic evaluations (HEEs) of intentional placebo interventions and to review studies that intentionally applied placebo interventions and reported outcomes eligible for HEEs. Methods: Two systematic reviews of the literature were performed. For the first review, we searched MEDLINE using “placebo” and Medical Subject Headings (MeSH) terms associated with HEEs such as “costs,” “cost–benefit analyses,” and “economics.” Studies were eligible if they employed patients, applied placebo interventions, included an appropriate control group, and reported results of cost analyses. For the second review, we searched the Journal of Interdisciplinary Placebo Studies (JIPS) database and MEDLINE using search terms for outcomes eligible for cost–utility analyses, such as “quality of life” or “quality-adjusted life years” (“QALYs”). Risk of bias of all studies found was assessed according to the Cochrane Handbook, and a narrative synthesis of the results is provided. Results: The first search resulted in 1,853 articles, which were screened for eligibility. Two studies were found only in which costs or cost-effectiveness analysis were reported, but with medium to high risks of biases. The second search yielded 164 articles particularly from the JIPS database of which 11 studies met our search criteria: in six studies, patients received placebo pills in open-label conditions; three studies investigated effects of patient–physician relationships; and two studies used psychological interventions to optimize treatment expectations, in patients with various diseases and disorders. These studies report outcomes potentially eligible for HEEs when costs of interventions were known. Risks of biases were low to medium, but patients were not blinded to the conditions in most studies. Conclusions: The state of knowledge about HEEs of placebo interventions is scarce. To gain more visibility and acceptability for placebo interventions, future studies should measure outcomes usable for HEEs and costs of interventions, and HEEs should be performed for existing studies if data are available.
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spelling pubmed-67517722019-09-30 Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect Hamberger, Jens Meissner, Karin Hinterberger, Thilo Loew, Thomas Weimer, Katja Front Psychiatry Psychiatry Background: Recent research shows that placebo mechanisms can be utilized in ethical and legal ways such as in open-label conditions, when patients know that they receive placebos, and through psychological interventions aiming to optimize patients’ expectations. Showing that placebo interventions are also cost-efficient could improve their acceptability. Objective: To review studies that performed health economic evaluations (HEEs) of intentional placebo interventions and to review studies that intentionally applied placebo interventions and reported outcomes eligible for HEEs. Methods: Two systematic reviews of the literature were performed. For the first review, we searched MEDLINE using “placebo” and Medical Subject Headings (MeSH) terms associated with HEEs such as “costs,” “cost–benefit analyses,” and “economics.” Studies were eligible if they employed patients, applied placebo interventions, included an appropriate control group, and reported results of cost analyses. For the second review, we searched the Journal of Interdisciplinary Placebo Studies (JIPS) database and MEDLINE using search terms for outcomes eligible for cost–utility analyses, such as “quality of life” or “quality-adjusted life years” (“QALYs”). Risk of bias of all studies found was assessed according to the Cochrane Handbook, and a narrative synthesis of the results is provided. Results: The first search resulted in 1,853 articles, which were screened for eligibility. Two studies were found only in which costs or cost-effectiveness analysis were reported, but with medium to high risks of biases. The second search yielded 164 articles particularly from the JIPS database of which 11 studies met our search criteria: in six studies, patients received placebo pills in open-label conditions; three studies investigated effects of patient–physician relationships; and two studies used psychological interventions to optimize treatment expectations, in patients with various diseases and disorders. These studies report outcomes potentially eligible for HEEs when costs of interventions were known. Risks of biases were low to medium, but patients were not blinded to the conditions in most studies. Conclusions: The state of knowledge about HEEs of placebo interventions is scarce. To gain more visibility and acceptability for placebo interventions, future studies should measure outcomes usable for HEEs and costs of interventions, and HEEs should be performed for existing studies if data are available. Frontiers Media S.A. 2019-09-12 /pmc/articles/PMC6751772/ /pubmed/31572237 http://dx.doi.org/10.3389/fpsyt.2019.00653 Text en Copyright © 2019 Hamberger, Meissner, Hinterberger, Loew and Weimer http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Hamberger, Jens
Meissner, Karin
Hinterberger, Thilo
Loew, Thomas
Weimer, Katja
Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title_full Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title_fullStr Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title_full_unstemmed Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title_short Placebo Economics: A Systematic Review About the Economic Potential of Utilizing the Placebo Effect
title_sort placebo economics: a systematic review about the economic potential of utilizing the placebo effect
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751772/
https://www.ncbi.nlm.nih.gov/pubmed/31572237
http://dx.doi.org/10.3389/fpsyt.2019.00653
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