A piece showing how oncologists in the U.S. have incentives to prescribe more expensive chemotherapy drugs, given that they apply a mark-up on drugs purchased from pharmacies (in Canada, as chemotherapy occurs in public hospital settings, with treatment protocols approved by province-wide guidelines, do not think this is an issue).
Harvard study documents the extent of this in the case of lung cancer drug alternatives. Oncologists may be doing this consciously or not, but it illustrates the importance of getting incentives right (and no matter how thoughtful the initial analysis, human behaviour is always more complex than we think). Quote:
Many oncologists vehemently deny being influenced by this financial conflict of interest. But such denials defy both logic and data. Oncologists would have to be superhuman not to be influenced, at least unconsciously, by such strong incentives. After all, there is often no single “best” way to treat any given tumor, and there’s often good reason to believe that expensive new therapies might be better than older, cheaper treatments. In the face of such uncertainty, how could oncologists avoid being influenced by the knowledge that those promising expensive new treatments also help generate so much income?