Identification of Financial Incentives in Irrational Use and Prescribing of Drugs: A Qualitative Study

Irrational use and prescribing of medications is a major problem in healthcare systems worldwide. The factors affecting prescribing and use of drugs can be assessed in educational, management, supervision and financial areas. Present study was designed to investigate the role of financial incentives in this field.

This qualitative study was conducted using a semi-structured interview in 2016. Participants included those who were well-informed and experienced in the field of rational use of drug. Sampling was done in a targeted way and 16 people were interviewed. Interviews were evaluated after the implementation of the theme analysis method.

In this qualitative study, four main themes and 12 sub themes were obtained. The main topics were: 1. Financial incentives for physicians (including: motivation for attracting more patients, earning more money, health insurance organizations' liabilities, community expectations of physicians' financial position, physician financial problems, and shifting physician's role from factor to performer), 2. Financial incentives for pharmacies (including: pharmacies' economic problems, health insurance organizations' liabilities, earning more money through over-the-counter sales of all medications, patient insistence and pharmacists' security), 3. Financial incentives for patients (including: self-medication and community poverty) and 4. Financial incentives for pharmaceutical companies (including: earning more profit by selling a particular brand).

Financial motivators are among the important intervening factors in irrational use and prescribing of medications. Providing appropriate financial solutions by policy makers and improving economic situation of the community can help the quality of medical services and improve status of prescribing and usage of medications.