The Effect of Rebranding Generic Medicines on Drug Efficacy and Side Effects

Kate MacKrill, University of Auckland
Maria Kleinstäuber, University of Auckland
Keith J. Petrie, University of Auckland


Objective: Branded medicines have a greater placebo effect, resulting in a heightened therapeutic response, whereas generics are associated with greater side effect reporting. These two studies investigated whether enhancing the appearance of a generic medicine could increase placebo and decrease nocebo responding. Design: Two experimental studies allegedly examining the effect of β-blockers (actually placebos) for pre-examination anxiety. In Study 1, participants received either a generic β-blocker with enhanced packaging, a plainly packaged generic or a branded β-blocker. Study 2 compared an enhanced packaging generic to a plainly packaged generic β-blocker. Main outcomes measures: Blood pressure, heart rate, anxiety and the number of symptoms and side effects reported. Results: Study 1 found no differences between the three groups for blood pressure, heart rate, or anxiety. Study 2 showed similar results but a significant difference in anxiety was found with the plain generic group experiencing a greater reduction in anxiety than the enhanced generic group. No differences in symptoms or side effects were found in either study. Conclusions: While the sample characteristics and familiarity of the medicines may have influenced the findings, we found no evidence that enhancing the branding of generic medicines improved response to the medication or reduced side effects.