Chapter Fifteen - The Power of Labeling in Nocebo Effects
Section snippets
Generic Medicines
Perhaps most associated with the concept of pharmaceutical labeling is originator brands versus generic medicine labeling. In pharmaceutical development, the originator brand name, e.g., Prozac or Viagra, is the name that is given by the manufacturer who developed, tested, and patented the medication (Chandler & Owen, 2002). Originator brand manufacturers are typically large pharmaceutical companies with wide recognition of their company name and logo. Incorporated into brand name labeling of a
Brand Name and Generic Labeling
As previously noted, at least one-third of the population holds one or more negative perceptions of generic medicines, including that generic drugs are less safe, less effective, of lower quality, more likely to cause side effects, and should not be substituted for their brand name equivalents (Colgan et al., 2015). Negative perceptions of generics appear to contribute to reduced treatment efficacy via primary nocebo effects—where negative beliefs reduce the primary or intended effect of a
Improving Perceptions of Generic Medicines
Although a substantial body of research has sought to investigate public and medical professionals’ perceptions of generic medicines, very little research has explored the utility of interventions to improve perceptions of generics. One experimental study tested the effect of a brief intervention on both perceptions of generics, and subsequent efficacy of an analgesic (ibuprofen) labeled as either a brand name or generic, in treating headache pain (Colgan et al., 2016). This study used a
Implications of Generic Labeling and Subsequent Nocebo Effects
Nocebo side effects are common in medical care; in some treatments they are likely to be responsible for the majority of reported side effects (Finegold et al., 2014; Mahr et al., 2017; Tobert & Newman, 2016). The studies reviewed in this chapter demonstrate how generic labeling and associated features of the treatment context can increase unpleasant side effects and decrease treatment efficacy. Primary nocebo effects—i.e., nocebo-induced reductions in treatment efficacy—and nocebo side effects
Conclusions
This chapter provides a comprehensive overview of research conducted to date examining the influence of generic labeling, and related attributes, on treatment outcomes. As more evidence becomes available, future work could usefully involve systematic reviews and meta-analyses of studies examining the influence of labeling on nocebo effects. However, at this relatively early stage, a narrative overview and discussion of this research is most appropriate. A range of aspects associated with
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