Doctors prescribing behaviour

More recently, large databases have been used to estimate the effect of drug co-payment in the USA under different insurance schemes.10 The conclusion reached is that there is a significant interaction effect between the behaviour of demand and prescriber incentives. Thus, larger prescription drug copayments are associated with lower expenditure when the doctor does not share the financial risk of the cost of the drugs (that is, practises in an independent practice association) but this effect is barely perceived in managed care models in which the doctor has incentives for cost containment. 

Mrs Jackson finished a meeting with the headmaster of her son s school. This was the third meeting since the start of this academic year. Her son John, who is only six years old, started school two months ago. Whilst his teachers could understand some hyperactivity in a six-year-old child, they expressed serious concerns regarding John s disruptive behaviour in the class. They found that John was having difficulty in focusing and was unable to remain in his seat, even for a short period. Mrs Jackson was very upset about all this and decided that John should see the family doctor. A diagnosis was made and the drug, methylphenidate, was prescribed. 

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