PRESCRIPTION DRUG MONITORING PROGRAMS The Role of Asymmetric Information on Drug Availability and Abuse
PRESCRIPTION DRUG MONITORING PROGRAMS The Role of Asymmetric Information on Drug Availability and Abuse
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DOI：
10.1162/ajhe_a_00101
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发表时间：
2018-09-01
影响因子：
3.7
通讯作者：
Meinhofer, Angelica
中科院分区：
文献类型：
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作者：
Meinhofer, Angelica
受管制处方药的转移可能通过“医生购物”出现，即患者从不同的医疗保健提供者那里获得多种处方，而提供者不知道其他处方。处方药监测项目（PDMPs）旨在解决信息不对称的问题。在本文中，我利用PDMP实施日期的跨州变化来估计PDMP对药物数量和死亡的影响。我通过分析阿片类药物内外处方药的结果，考虑到非法药物市场的溢出效应，并依靠2000-13年间的高频行政数据，扩展了以前的工作。我还估计了两种可能缩小提供者之间信息不对称的PDMP特性的影响：直接PDMP访问和必要的PDMP使用。我发现PDMP的实施和直接访问PDMP对结果都没有显著影响。这些发现适用于所有药物类别、药物市场和规格。然而，我发现证据表明，PDMP的使用使处方阿片类药物和兴奋剂的数量分别减少了9%和11%。反过来，处方阿片类药物和苯二氮卓类药物的死亡率分别下降了9%和13%。我还发现，尽管证据不足，但非法毒品致死人数有所增加。
The diversion of controlled prescription drugs can arise through "doctor shopping," where a patient obtains multiple prescriptions from different health-care providers without the providers' knowledge of the other prescriptions. Prescription Drug Monitoring Programs (PDMPs) aim to address this problem of asymmetric information. In this paper, I exploit cross-state variation in PDMP implementation dates to estimate the effect of PDMPs on drug quantities and deaths. I expand upon previous work by analyzing outcomes for prescription drugs within and outside the opioid class, by considering spillovers into the illegal drug market, and by relying on high-frequency administrative data spanning the years 2000-13. I also estimate the effect of two PDMP characteristics with the potential to narrow information asymmetries among providers: direct PDMP access and required PDMP use. I find that neither PDMP implementation nor direct PDMP access had a significant effect on outcomes. These findings hold across drug classes, drug markets, and specifications. I find evidence, however, suggesting that required PDMP use reduced prescription opioid and stimulant quantities by 9 percent and 11 percent, respectively. In turn, prescription opioid and benzodiazepine deaths decreased by 9 percent and 13 percent, respectively. I also find evidence, albeit weak, suggesting that illegal drug deaths increased.