DOING THE MATH

Parsing that Botox Commercial

There I was, recumbent in my lounger watching some forgotten TV show last night, when this Botox commercial pops up.  Should I have post-menopausal headaches, I am told, maybe Botox injections can help.

Leaving aside the obvious, the legal / scientific caveat pops up on the screen.  Let me write it down here, as close to word for word as I can remember:

"Botox prevents up to 9 headache days per month, versus up to 7 for placebo."

Just to make sure we're on the same page, a placebo is a medication that has no pharmacological value - is inert and harmless and the same as taking nothing at all.  Except for one thing - the person taking it THINKS they're taking medication and expects it to help.  If it helps, that is called the "placebo effect."  It helps because the person thinks it's helping.  In reality it is doing nothing at all.

At first that just bounced off my GAS (Give a S--t) filters, then it hit me:  Placebo 7, Botox 9.  That means that the up to 9 headache days per month prevented by Botox includes 7 days prevented by the placebo effect.  So the person buying the injections is paying for an additional 2 days.  Looked at another way, the Botox is statistically providing 22% of the relief-days the customer is experiencing, while the placebo effect is providing the other 78%. 

What does all this say about post-menopausal headaches?  Yes, your Ostrich Killer will tell you, passing along the wisdom of my mother whenever I complained of some non-injurious, non-feverish malaise:  "It's all in your head, Sweetheart.  Go out and play."

Good advice.

Of course you're going to point out that one cannot go out and buy a placebo, because doing so would subvert the value of a placebo.  One would know it is a placebo and would therefore NOT expect it to work - so of course it wouldn't.  That's the sort of thing that Joseph Heller would appreciate: if you don't know what you're buying it works, but if you do know it doesn't.

Truth in advertising.  Ain't it wonderful?  Now go out and play.