* The drug provides a modest health improvement.
* That health improvement happens to be smaller than the health improvement do to the placebo effect?
I don't know what the typical magnitude of the placebo effect is. If it is substantial, then actually working, actually helpful drugs might be being denied to people. The very mechanisms for the placebo effect he hypothesizes (e.g. people taking care of their health when on a study) certainly seem like they might vary with our culture...