Provider incentives and prescribing behavior in Europe

European policy makers have increasingly moved from primarily focusing on supply-side regulation of pharmaceutical costs to offering incentives for providers’ prescribing behavior. The nature and implementation of these provider-focused policies are as diverse as the health systems in which they are enacted. Some policies have undergone significant alteration since their initial implementation as health system design has changed and experience has yielded greater knowledge of the types of policy that achieve results in practice. Evaluation of prescribing incentive policies in several European countries is constrained by a lack of comprehensive information systems tracking prescriptions. Analysis of policy experience suggests that policy ought to be formulated with clarity and transparency of objectives, also keeping in mind the ethical concerns associated with rewards and fines for prescribing levels when the professional aspirations of doctors include maintenance of quality care and some degree of autonomous decision making.