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Impact of a physician-targeted letter on opioid prescribing

Author

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  • Ahomäki, Iiro
  • Pitkänen, Visa
  • Soppi, Aarni
  • Saastamoinen, Leena

Abstract

We study the effect of a physician-targeted nudge letter on opioid prescribing. In May 2017, the Social Insurance Institution of Finland sent a personal information letter to all physicians who had issued a prescription containing at least 100 tablets of paracetamol-codeine combination to a new patient. The aim of the letter was to draw the physicians’ attention to their prescribing practices and to decrease the size of the first codeine prescription. Using individual level register data and a difference-in-differences strategy, we estimate that the letter decreased the average number of tablets purchased by new patients by 12.5 percent and the probability of a first purchase being at least 100 tablets by six percentage points. We also find that these effects were larger among consistent high prescribers. However, we do not find similar effects on other mild or strong opioids.

Suggested Citation

  • Ahomäki, Iiro & Pitkänen, Visa & Soppi, Aarni & Saastamoinen, Leena, 2020. "Impact of a physician-targeted letter on opioid prescribing," Journal of Health Economics, Elsevier, vol. 72(C).
    • Handle: RePEc:eee:jhecon:v:72:y:2020:i:c:s0167629619307891
    DOI: 10.1016/j.jhealeco.2020.102344
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    1. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    2. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 383-410, Summer.
    3. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    4. McMichael, Benjamin J. & Van Horn, R. Lawrence & Viscusi, W. Kip, 2020. "The impact of cannabis access laws on opioid prescribing," Journal of Health Economics, Elsevier, vol. 69(C).
    5. Richard G. Frank, 2004. "Behavioral Economics and Health Economics," NBER Working Papers 10881, National Bureau of Economic Research, Inc.
    6. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    7. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    8. Phelps, Charles E., 2000. "Information diffusion and best practice adoption," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 5, pages 223-264, Elsevier.
    9. Hallsworth, Michael & List, John A. & Metcalfe, Robert D. & Vlaev, Ivo, 2017. "The behavioralist as tax collector: Using natural field experiments to enhance tax compliance," Journal of Public Economics, Elsevier, vol. 148(C), pages 14-31.
    10. Böckerman, Petri & Kortelainen, Mika & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2019. "Digital Waste? Unintended Consequences of Health Information Technology," Working Papers 117, VATT Institute for Economic Research.
    11. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    12. Matikka, Tuomas & Paukkeri, Tuuli, 2016. "Does information increase the take-up of social benefits? Evidence from a new benefit program," Working Papers 83, VATT Institute for Economic Research.
    13. Hunt Allcott & Todd Rogers, 2014. "The Short-Run and Long-Run Effects of Behavioral Interventions: Experimental Evidence from Energy Conservation," American Economic Review, American Economic Association, vol. 104(10), pages 3003-3037, October.
    14. Juan M. Villa, 2016. "diff: Simplifying the estimation of difference-in-differences treatment effects," Stata Journal, StataCorp LP, vol. 16(1), pages 52-71, March.
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    2. Maria Vittoria Levati & Ivan Soraperra & Saba Yifredew, 2023. "How to Curb Over-The-Counter Sales of Antibiotics? Evidence from a Field Experiment in Ethiopia," Working Papers 10/2023, University of Verona, Department of Economics.

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    More about this item

    Keywords

    Opioid prescribing; Information letter; Prescription drugs; Difference-in-differences;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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