Does it matter whether or not pain medication is branded?

Around the world many health services are moving towards generic (non-branded) medicines as a way to reduce costs. Where does psychology come into this? Well, we know that, thanks to the placebo effect, people's expectations about a treatment can influence the effects that treatment has on them.

We also know, thanks to research conducted over the last decade, that people expect branded medicines to be more effective and to have fewer side effects than their generic counterparts. A new study in Health Psychology is one of the first to explore whether this matters – specifically, it looks at whether a generic painkiller is less effective than its chemically identical branded counterpart.

Kate Faasse and her colleagues recruited 87 undergrads, most of them were female, who answered an advert seeking people who suffer frequent headaches (at least one per fortnight). The participants were given four doses of Ibuprofen to use in the coming weeks as and when they suffered a headache, and to keep a diary of the relief the medicine brought them, and any side-effects they experienced. Crucially, two of the doses were branded as Nurofen, while the other two were generic in plain packaging. Unbeknown to the participants, one of the branded doses was actually a placebo, as was one of the generic doses.

When it came to the active doses, there was no difference between the branded and generic Ibuprofen – both were equally effective at pain relief and the students reported the same amount of side-effects for each. However, with the placebo doses, the branded medicine was more effective than the generic at pain relief and was associated with fewer side effects than the generic medicine.

Although these findings imply that branding makes no difference to an active pain relief medicine, they do show how branding exerts a placebo effect in terms of pain relief and reduced side-effects. This placebo effect was not detectable beyond the actions of the active medicine.

But Faasse and her colleagues explained that this branding-related placebo effect could have real-life significance for other types of medicine for which the actions of the drug are less easy for patients to monitor or detect (as compared with pain relief), such as blood pressure medication or anti-depressants, meaning that the patients' beliefs about the drug might be more important. We'll need more research to test this.

The researchers said: "The additional placebo effect associated with branding has the potential to enhance medication effectiveness, which may subsequently be lost during a switch to a generic alternative".

References

Faasse, K., Martin, L., Grey, A., Gamble, G., & Petrie, K. (2015). Impact of Brand or Generic Labeling on Medication Effectiveness and Side Effects. Health Psychology DOI: 10.1037/hea0000282