Working Paper: NBER ID: w26159
Authors: Thomas C. Buchmueller; Colleen M. Carey; Giacomo Meille
Abstract: Many opioid control policies target the prescribing behavior of health care providers. In this paper, we study the first comprehensive state-level policy requiring providers to access patients' opioid history before making prescribing decisions. We compare prescribers in Kentucky, which implemented this policy in 2012, to those in a control state, Indiana. Our main difference-in-differences analysis uses the universe of prescriptions filled in the two states to assess how the information provided affected prescribing behavior. As many as forty percent of low-volume opioid prescribers stopped prescribing opioids altogether after the policy was implemented. Among other providers, the major margin of response was to prescribe opioids to approximately sixteen percent fewer patients. While providers disproportionately discontinued treating patients whose opioid histories showed the use of multiple providers, there were also economically-meaningful reductions for patients without multiple providers and single-use acute patients.
Keywords: opioid prescribing; drug monitoring programs; health policy
JEL Codes: H75; I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Kentucky's mandatory access PDMP (I19) | reduction in the percentage of providers writing opioid prescriptions (L42) |
| Kentucky's mandatory access PDMP (I19) | decrease in average number of patients treated with opioids (I12) |
| Kentucky's mandatory access PDMP (I19) | decrease in prescriptions to patients with histories of doctor shopping (I11) |
| Kentucky's mandatory access PDMP (I19) | statistically significant reductions in prescribing to single-use patients (I11) |
| Kentucky's mandatory access PDMP (I19) | statistically significant reductions in prescribing to non-shopping patients (I11) |