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How Well Do Doctors Know Their Patients? Evidence from a Mandatory Access Prescription Drug Monitoring Program

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  • 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.

Suggested Citation

  • Thomas C. Buchmueller & Colleen M. Carey & Giacomo Meille, 2019. "How Well Do Doctors Know Their Patients? Evidence from a Mandatory Access Prescription Drug Monitoring Program," NBER Working Papers 26159, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:26159
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    References listed on IDEAS

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    1. Angélica Meinhofer, 2018. "Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse," American Journal of Health Economics, University of Chicago Press, vol. 4(4), pages 504-526, Fall.
    2. William N. Evans & Ethan M. J. Lieber & Patrick Power, 2019. "How the Reformulation of OxyContin Ignited the Heroin Epidemic," The Review of Economics and Statistics, MIT Press, vol. 101(1), pages 1-15, March.
    3. Kennedy-Hendricks, A. & Richey, M. & McGinty, E.E. & Stuart, E.A. & Barry, C.L. & Webster, D.W., 2016. "Opioid overdose deaths and Florida's crackdown on pill mills," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 291-297.
    4. 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.
    5. 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.
    6. Angélica Meinhofer, 2018. "Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse," American Journal of Health Economics, MIT Press, vol. 4(4), pages 504-526, Fall.
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    Cited by:

    1. Mayank Aggarwal & Anindya S. Chakrabarti & Chirantan Chatterjee, 2023. "Movies, stigma and choice: Evidence from the pharmaceutical industry," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1019-1039, May.
    2. Alice M. Ellyson & Jevay Grooms & Alberto Ortega, 2022. "Flipping the script: The effects of opioid prescription monitoring on specialty‐specific provider behavior," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 297-341, February.

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    More about this item

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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