Comparative Effectiveness Research Not Aligned with Financial Incentives

Taxpayer-funded research findings in the last decade have altered clinical knowledge about the best way to treat patients, but five obstacles, the biggest of which is perverse financial incentives, keep physicians from adopting them for their patients.

That's the message from RAND researcher Justin Timbie and colleagues, who report their conclusions in the October issue of Health Affairs.

"The difference between reimbursements in some of these treatments is so huge, it can sway decision-making at the point of care," Timbie says. "This misalignment of financial incentives that slow adoption of comparative effectiveness research evidence is probably the biggest, thorniest challenge we have today."

He adds, "financial interests can influence how physicians and patients interpret the results of new research, through marketing and through messaging of different sorts. 

"Additionally," he says, "the industry has funded opinion leaders and has conducted marketing campaigns to spread particular interpretations of these studies' results."  Biases also impact the formalization of guidelines that professional societies produce to guide physicians, he says.