Non-financial incentives

In Chapter 9, lecturers V. Ortun Rubio of Pompeu Fabra University and L. Cabiedes Miragaya of the University of Oviedo address the subject of measures intended as a way of influencing prescriber decisions. The authors place special emphasis on analysing prescriber incentive policies, distinguishing between incentives of a financial nature (both coercive and non-coercive) and non-financial incentives (information, training, treatment protocols, monitoring of prescription practices, cost-effectiveness guidelines, interaction with other professionals, pressure from patients and so on). The authors advocate incentive policies based on a combination of financial and non-financial incentives. 

To summarize, it should be highlighted that in general terms the issue of prescribing incentives is approached with a marked lack of consideration of such fundamental concerns as their impact on health, although this aspect is indirectly addressed by non-financial incentives and mixed formulas such as those discussed above. Financial incentives alone appear to lack effectiveness as instruments of pharmaceutical policy. Incentives aimed at prescribers should under no circumstances create a clash of interests between their fees and the quality of the care they provide for their patients, and therefore adjustment must be made in these terms. In turn, we cannot ignore that the effect of this type of mechanism on physicians behaviour will depend on, among other factors, the quality of available information on the aspects taken into consideration in their application. 

This chapter on prescriber incentives brings together various midpoints, all of them difficult to find. One of these midpoints concerns incentives (if there is one distinguishing feature of health care organizations it is the advisability of moderating the power of incentives in order to stop financial considerations from short-circuiting clinical considerations) another concerns the balance between health policy issues and industrial policy ones and a third concerns the influences exerted on prescription by the market, the state and clinical standards (the combination of financial and non-financial incentives). 

Over a number of years, the photovoltaic cell developers received large financial incentives from the U.S. government, For example, the National Photovoltaics Act of 1978 was passed by the IT.S. Congress, which authorized an expenditure of 1.5 billion for research, development, and demonstration of solar cell systems for converting sunlight into electric power, Also, in connection with the Federal Non-Nuclear Energy Research and Development Act of 1974, which established the concept of net... 

Wlien ownership rights are less well defined, or not easily defended, the incentives for resource owners to efficiently use resources in a safe, non—polluting way, are decreased or removed. Individuals are less likely to take expensive, time-consuming action to protect a resource that they do not own, and by which they are not directly affected financially. For instance, most landowners would be quick to take action to prevent garbage generated by a local business from piling up in their own backyard. However, they would be less likely to take actions to prevent the same business from polluting a nearby lake or river. The reason is that any one individual has less direct, or at least less obvious, interest in the lake or river, than they do in their own property—and usually less ability to affect the outcome. 

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