Not so great expectations: The role of price and name information in the nocebo effect
Background: The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exace...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | Exploratory Research in Clinical and Social Pharmacy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266727662500071X |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849319442839764992 |
|---|---|
| author | Kiarne Humphreys Michelle Lin Kirsten Barnes Yasmin Hasan Ashwin Vignaraja Kritika Sarna Andrew L. Geers Kate Faasse |
| author_facet | Kiarne Humphreys Michelle Lin Kirsten Barnes Yasmin Hasan Ashwin Vignaraja Kritika Sarna Andrew L. Geers Kate Faasse |
| author_sort | Kiarne Humphreys |
| collection | DOAJ |
| description | Background: The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exacerbate negative expectations and cause nocebo effects. Methods: Healthy participants (N = 196) were randomised to receive sham-oxytocin nasal spray associated with either a generic (complex name, low price; n = 66) or brand (simple name, high price; n = 68) cue, or to no treatment control (n = 62). Participants were informed that oxytocin could enhance trust and cooperation, but might cause side effects of headache, nausea, vomiting, rapid heartbeat, feeling faint or light-headed, and skin itching or rash. Treatment-related side effects were assessed at baseline, and after 3 days of sham-oxytocin use. Results: Nocebo effects were observed across sham-treated participants relative to control (p = .015; d = 0.28). Association with a generic relative to branded cue significantly enhanced nocebo effects (p = .042; d = 0.36). Negative expectations mediated the observed nocebo and branding effects. Conclusions: Cues associated with generic medications can exacerbate nocebo effects and these findings may explain clinical observations of increased side effects from generic medications. Results have important implications for medical care, and interventions to mitigate nocebo effects from generic medications are needed. |
| format | Article |
| id | doaj-art-ed0efddac8f0404cb6d88c0398b4e160 |
| institution | Kabale University |
| issn | 2667-2766 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj-art-ed0efddac8f0404cb6d88c0398b4e1602025-08-20T03:50:26ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662025-09-011910063010.1016/j.rcsop.2025.100630Not so great expectations: The role of price and name information in the nocebo effectKiarne Humphreys0Michelle Lin1Kirsten Barnes2Yasmin Hasan3Ashwin Vignaraja4Kritika Sarna5Andrew L. Geers6Kate Faasse7School of Psychology, University of New South Wales, Sydney, NSW, AustraliaSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaSchool of Psychology, University of New South Wales, Sydney, NSW, AustraliaDepartment of Psychology, University of Toledo, Toledo, OH, USASchool of Psychology, University of New South Wales, Sydney, NSW, Australia; Corresponding author at: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia.Background: The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exacerbate negative expectations and cause nocebo effects. Methods: Healthy participants (N = 196) were randomised to receive sham-oxytocin nasal spray associated with either a generic (complex name, low price; n = 66) or brand (simple name, high price; n = 68) cue, or to no treatment control (n = 62). Participants were informed that oxytocin could enhance trust and cooperation, but might cause side effects of headache, nausea, vomiting, rapid heartbeat, feeling faint or light-headed, and skin itching or rash. Treatment-related side effects were assessed at baseline, and after 3 days of sham-oxytocin use. Results: Nocebo effects were observed across sham-treated participants relative to control (p = .015; d = 0.28). Association with a generic relative to branded cue significantly enhanced nocebo effects (p = .042; d = 0.36). Negative expectations mediated the observed nocebo and branding effects. Conclusions: Cues associated with generic medications can exacerbate nocebo effects and these findings may explain clinical observations of increased side effects from generic medications. Results have important implications for medical care, and interventions to mitigate nocebo effects from generic medications are needed.http://www.sciencedirect.com/science/article/pii/S266727662500071XNocebo effectExpectationsGeneric medicationSide effectsPriceDrug names |
| spellingShingle | Kiarne Humphreys Michelle Lin Kirsten Barnes Yasmin Hasan Ashwin Vignaraja Kritika Sarna Andrew L. Geers Kate Faasse Not so great expectations: The role of price and name information in the nocebo effect Exploratory Research in Clinical and Social Pharmacy Nocebo effect Expectations Generic medication Side effects Price Drug names |
| title | Not so great expectations: The role of price and name information in the nocebo effect |
| title_full | Not so great expectations: The role of price and name information in the nocebo effect |
| title_fullStr | Not so great expectations: The role of price and name information in the nocebo effect |
| title_full_unstemmed | Not so great expectations: The role of price and name information in the nocebo effect |
| title_short | Not so great expectations: The role of price and name information in the nocebo effect |
| title_sort | not so great expectations the role of price and name information in the nocebo effect |
| topic | Nocebo effect Expectations Generic medication Side effects Price Drug names |
| url | http://www.sciencedirect.com/science/article/pii/S266727662500071X |
| work_keys_str_mv | AT kiarnehumphreys notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT michellelin notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT kirstenbarnes notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT yasminhasan notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT ashwinvignaraja notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT kritikasarna notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT andrewlgeers notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect AT katefaasse notsogreatexpectationstheroleofpriceandnameinformationinthenoceboeffect |