Real World Evidence and the Behavioral Economics of Physician Prescribing

The projections for the rising cost of health care have spurned robust dialogue from every sector of the healthcare economy [1,2] Among the many targets for cost control are specialty drugs distinguished clinically by their route of administration, synthesis or bioengineering, mechanism of action and cost itself [2]. This terminology likely originated from payers who designate these drugs for special attention not only because of price, but also the need for distinctive handling or particular patient monitoring [3]. Although there are examples of competition emerging to tamp down prices to more acceptable levels (e.g. pharmacy benefit manager negotiations for hepatitis C drugs), stakeholders (policy-makers, insurance carriers, and non-governmental groups such as ASCO) are seeking other market-based solutions [2].