The Placebo Effect

The manufacturer of a leading brand of painkiller has been accused of misleading customers in Australia. But how do people choose over-the-counter pain relief?

There’s a whole range of Nurofen products. There are Nurofen capsules, caplets and “meltlets”. Some are marketed to treat specific problems – Nurofen Migraine Pain or Nurofen Tension Headache.But Nurofen maker Reckitt Benckiser has been ordered to take some of these “specific pain” products off the shelves in Australia. A court decided they were misleading consumers because the packaging made it seem as though they had been formulated to treat different types of pain. In fact, these products contained the same active ingredient – 342 mg of ibuprofen lysine. Reckitt Benckiser says that they are just meeting demand. They argue that 88% of people look for relief for a specific type of pain. Packaging tablets with clear labels saying “back pain” or “period pain” makes it easier for people to decide which one to get to meet their needs, they add.

But take this scenario. A customer has a packet of Nurofen Migraine Pain in their handbag. They suffer a tension headache. They buy Nurofen Tension Headache. By the Australian court’s view they are completely wasting their money – it’s fundamentally the same medicine in different packaging. All of these specific pain versions cost about double the price of Nurofen’s standard version in Australia. The formulations used in Nurofen’s specific pain range in Australia contain lysine and sodium. The manufacturer says that this allows them to be absorbed faster than the standard version. In the UK, similar medication is sold. Nurofen Migraine Pain and Nurofen Tension headache caplets have identical active ingredients. They contain the same 342mg of ibuprofen lysine that is in the Australian versions. But no legal action has been taken against Nurofen in the UK.

When someone swallows a general painkiller such as ibuprofen it’s distributed around the whole body through the bloodstream. Painkillers targeting specific areas will treat the areas in pain but they cannot be sent directly to a particular part of the body. The discrepancy in price between different versions of branded painkiller is arguably no stranger than the variation in price between brands like Nurofen, and the generic equivalents that sit near by them on supermarket shelves. Somebody could walk into a Tesco in the UK and spend £2 on a packet of 16 Nurofen when a packet of 16 generic ibuprofen tablets – an identical drug – is just 30p.

“You’re paying for the marketing essentially and the shiny box,” argues Sheikh. She tends to recommend using cheaper generic painkillers, but says that many of her patients are still loyal to certain brands.

The placebo effect could help explain this. “Just knowing that you’ve taken something can make you feel better,” explains Sheikh. Believing in a particular brand can also have a big impact. In a recent study, researchers gave people with frequent headaches a dummy pill. Some of these placebos were packaged as branded painkillers and some weren’t. The branded ones were reported to be more effective at pain relief by those in the study and were associated with fewer side effects than the placebos packaged as generic medication._87199363_istock_000011206872_largeInformation from BBC Health


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