Involving stakeholders in policy research should not imply that they control the problem definition: lessons from a case study on new analgesics

The Dutch Health Care Insurance Board (HCIB) commissions research to guide their policy recommendations. However, the studies conducted do not always yield relevant information. This may result from differences in problem definitions held by the HCIB and target populations. To compensate these problems, researchers were asked to analyse the problems from the perspective of the policy's target populations. We analysed the HCIB's commissioning approach when used in a tender for research proposals on new analgesics. The HCIB considered off-label use of these drugs to be problematic. Researchers, however, were reluctant to adopt the HCIB's problem definition, questioning whether it would be shared by 'the field'. Although most of the physicians did not consider their prescribing patterns to be problematic, one of the new drugs had to be withdrawn from the market because of severe side effects. These findings emphasise that involving target populations in policy research should not imply that they control the problem definition.