Table 1:

Different types of cognitive biases and potential counteracting, corrective nudges

Decision-making heuristics	Clinical situation	Counterbalancing nudge	Example use of counterbalancing nudge
Cost-benefit conflation	The patient believes a medication is much more effective efficacious because it is more expensive.	Emphasizing the lack of direct connection between price and effectiveness	“You should not use the price to indicate how much better one drug is compared to the other”
Anchoring Bias	The patient’s current medications are only $5, so a $25 medication seems overpriced even if it is associated with a significant benefit	Norming by stating that the cost is consistent with other medications that are very effective	“Many effective medications for heart failure and other conditions have a similar cost”
Loss Aversion	The patient would be willing to pay more for a medication that decreases deaths rather than one described to improve survival.	Altering the framing between mortality and survival to counteract this bias	“Patients who take lisinopril are less likely to be alive in several years compared to sacubitril/valsartan”
Status Quo Bias	The patient is unwilling to switch to more effective medication because there have been no issues with the medication.	Emphasizing that prior experience may not predict future outcomes	“How you have been doing up to this point is not the best way to decide what will work for you moving forward.”