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Real-world evidence and the behavioral economics of physician prescribing

June 2017

To what extent does the human element of behavioral economics influence physician prescribing behavior?


Healthcare stakeholders are currently engaged in robust dialogue about ways to control the ever-rising costs of healthcare. Specialty drugs are among the many targets for these cost-control measures due to their high cost and complexity. Specifically, the fee-for-service payment system and its “buy-and bill” model have been identified as a main cost driver.

Many argue that the “buy-and-bill” model encourages physicians to overprescribe, creates incentives for price inflation and drives up costs. Physicians reject this unflattering portrayal, which demeans their professional integrity by suggesting they are motivated by financial incentives and behavioral economics.

However, behavioral economics can influence “rational” economic action and physicians, being human, are subject to irrational behavior in both their personal and professional lives. To what extent is the practice of evidence-based medicine impacted by the reality of human thought?

Dr. Bruce Feinberg, DO, Chief Medical Officer for Cardinal Health Specialty Solutions, conducted a study using an Oncology Medical Home pilot that removed economic incentives and found that opportunities to maximize revenue did not alter physician behavior or prescribing patterns. 

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