Selected Evidence in Behavioral Insights: Shaping Prescription Behavior is feasible

Behavioral insights integrate the understanding of how people perceive things, how they decide, and how they behave. Building on scientific evidence from psychology, behavioral economics and other disciplines, they hold the potential to address unanswered questions in healthcare with effective new strategies.


We are pleased to share some insights and present a publication by Monsen et al. (2019) which shows how "well-designed medication transparancy leads to more cost-conscious prescribing".


Subtle strategies can change prescribing habits

A central statement from Behavioral Insights is that the decision context strongly influences the decision made. In line with this, Monsen et al. (2019) show that a cost comparison for the original drug and lower-cost alternatives of equal safety and efficacy serves as a subtle strategy to significantly reduce medical spending - without limiting choice.

Figure 1: Executed behavior change after confrontation with strategy.


When attempting to place an order for one of four medications (topical clobetasol propionate, doxycycline hyclate, fluoxetine tabs, and high-cost triptans), prescribing clinicians received an alert requiring action:


[Ordered medication name] is more expensive than [alternative name], costing about $[cost of ordered medication] vs $[cost of alternative medication] per [unit of prescription]. UW Pharmacy and Therapeutics recommends the less expensive [alternative name].


Substitute by selecting one of the options below or “Continue with the Original Order.


During the 12-week intervention period compared to the previous 24-week baseline period, overall prescription volume for the high-cost medications decreased by 32% (p<.0001). As shown in the graph (Fig. 1), there were large differences between medications. This demonstrates the importance of avoiding restrictive strategies and allowing physicians the freedom to choose between medications and prescribing the more expensive one if necessary.


Our three key insights:

  1. Radical cost savings are feasible with minor adaptions in the prescription process.

  2. The prescriber’s habit of sticking to the same medication can be broken, cheaper alternatives (e.g. generics and biosimilars) are an appealing alternative if presented appropriately.

  3. Certain medications are less likely to be replaced. Behavioral insights strategies are therefore well suited because they do not restrict the free choice of decision makers.

About this post: This article was elaborated with our cooperation partner Verhaltensarchitektur GmbH. The article covers adapted information provided by Monsen et al. (2019).

About First Aid Marketing GmbH: We are a service provider for the healthcare industry with focus on scientific evidence, market research and health economics.