The Placebo Effect

BOTOX is the only FDA-approved, preventive treatment that is injected by a doctor every 12 weeks for adults with Chronic Migraine (15 or more headache days a month, each lasting 4 hours or more). BOTOX prevents up to 9 headache days a month (vs up to 7 for placebo). BOTOX therapy is not approved for adults with migraine who have 14 or fewer headache days a month.
– Allergan website, April 18, 2016
I’ve had four or five true migraines in my life, mostly from getting whacked on the head with something like a baseball or a sharp elbow in basketball, and I honestly can’t imagine how horrible it must be to suffer from chronic migraines, defined by the FDA as 15 or more migraines per month with headaches lasting at least four hours. So I was happy to see a TV ad saying that the FDA had approved Botox as an effective treatment for chronic migraines, preventing up to 9 headache-days per month. That’s huge!
But in the fast-talking coda for the ad, I heard something that made me do a double-take. Yes, Botox can knock out up to 9 headache days per month. But a placebo injection is almost as good, preventing up to 7 headache-days per month.
Now 9 is better than 7 … I get that … and that’s why the FDA approved the drug as efficacious. Still. Really? Most of the reports I’ve read say that the cost of a Botox migraine treatment is about $600. That’s just the cost of the drug itself. So what the FDA is telling us is that a saline solution injection (costing what? $2) is almost 80% as effective as the $600 drug, so long as it was presented to the patient as a ‘true’ potential therapy. If I’m an Allergan shareholder I’m thanking god every day for the placebo effect.

This post was published at FinancialSense on 04/21/2016.