Pharmaceutical policies are generally based on the assumption that involved stakeholders make rational decisions, as adopted from classical economic theory. However, behavioral economics has taught us that this is not always the case since people tend to deviate from rational behavior in rather predictable patterns. Many European countries have been struggling to define effective policies to promote the usage of cost-effective biological medicines or best-value biologicals, with the aim to increase the financial sustainability of national healthcare systems. Behavioral economics' insights carry the potential to increase the effectiveness of existing policy interventions.
Objective: This scoping review examined to what extent behavioral concepts have already been applied in the pharmaceutical domain and what evidence exists about their effectiveness, with the aim of formulating future applications and research hypotheses for policy frameworks to promote the use of best-value biological medicines.
Methods: A scoping literature review was conducted on the evidence of behavioral applications in the pharmaceutical domain. Scientific databases (Embase, Medline, APA PsycArticles, and Scopus) were searched up to 20 October 2021.
Results: Forty-four full-text scientific articles were identified and narratively described. Pharmaceutical domains where behavioral concepts have been investigated to date relate to influencing prescribing behavior, improving medication adherence, and increasing vaccination uptake. Multiple behavioral concepts were examined in the identified studies, such as social norms, defaults, framing, loss aversion, availability, and present bias. The effectiveness of the applied interventions was generally positive, but depended on the context. Some of the examined interventions can easily be translated into effective policy interventions for best-biologicals. However, some applications require further investigation in a research context.
Conclusions: Applications of behavioral economics to pharmaceutical policymaking are promising. There are multiple entry points for applying these concepts to best-value biological policies, such as gainsharing, prescribing quota, electronic prescribing software, patient communication, and healthcare provider education or information. Some of the examined applications can easily be extrapolated to existing policies, others need to be further examined in this context.