Working Paper: NBER ID: w26356
Authors: Thuy D. Nguyen; W. David Bradford; Kosali I. Simon
Abstract: Prior work considers effects of prescribing restrictions on opioid use but not upstream implications for pharmaceutical marketing activities, despite the inordinate role many believe marketing played in the crisis. Our study proposes a stylized model of pharmaceutical payments and investigates the impact of Mandatory Access Prescription Drug Monitoring Programs (MPDMPs) on opioid-specific commercial promotion directed at physicians. We find that MPDMPs reduce promotion on both extensive and intensive margins. Our results are consistent with economic theory, predicting lower promotional activities when return on investment decreases after state prescribing restrictions, and indicative of MPDMPs' role in affecting opioid use through reduced promotion.
Keywords: opioid prescribing; pharmaceutical promotion; prescription drug monitoring programs
JEL Codes: I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | reduction in opioid-related pharmaceutical promotion directed at physicians (L42) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | reduction in dollar amount of opioid-related promotion (L42) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | reduction in frequency of promotional visits to physicians (L42) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | negative impact on pharmaceutical manufacturer payments to physicians (H51) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | more severe impact on low-volume prescribers compared to high-volume prescribers (I11) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | no significant effects on detailing efforts in other drug markets (D49) |
| mandatory prescription drug monitoring programs (MPDMPS) (I18) | less pronounced reduction in promotional activities for high-volume prescribers (L42) |