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Pennsylvania Convention Center, 203-B
Hosted By:
American Economic Association
healthcare 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% and 11%, respectively. In turn, prescription opioid and benzodiazepine deaths decreased by 9% and 13%, respectively. I also find evidence, albeit weak, suggesting that illegal drug deaths increased.
Health Economics
Paper Session
Sunday, Jan. 7, 2018 10:15 AM - 12:15 PM
- Chair: Seth Richards-Shubik, Lehigh University
Health Insurance and the Boomerang Generation: Did the 2010 ACA Dependent Care Provision Affect Geographic Mobility and Living Arrangements Among Young Adults?
Abstract
To take full advantage of the Affordable Care Act (ACA) dependent care provision, young adults must live within their parents’ health provider networks, which typically encompass small geographic areas. This may induce young adults to live with or near their parents. In this paper, we test whether the ACA dependent care provision is associated with young adults’ propensity to live with or near their parents. We also examine young adults’ receipt of public program assistance, since living with/near parents may affect the need or eligibility for such assistance. Data come from the 2008 Survey of Income and Program Participation (SIPP). The findings indicate that the ACA dependent care provision is associated with a statistically significant 3.5 percentage point increase in the likelihood young adults live with their parents during the period the ACA was passed but the provision had not yet become effective (March 2010 to September 2010), and a 6.2 percentage point increase during the time period between when the provision became effective and the end of 2013 (October 2010 to November 2013). The pattern of findings suggests that these effects are driven by young adults moving from living independently into living in their parents’ households. In addition, in some specifications, we find that the ACA dependent care provision is associated with reduced use of federal food and nutrition programs, suggesting that assistance from parents may displace support from public programs.Opioid Use and Duration of Disability
Abstract
This study examines whether differences in opioids prescribing patterns influence duration of temporary disability benefits received by workers after a work-related injury. The study contributes to the literature by using methods designed to isolate a causal impact of opioids use on duration of disability. Specifically, we use local area variation in opioids prescriptions to construct instrumental variables for whether a given injured worker was given prescriptions for opioids. The idea behind this approach is that local prescribing patterns may influence whether an injured worker will use opioids. Indeed, we show that workers who live in areas where physicians are more likely to prescribe opioids were more likely to receive and fill opioids prescriptions, suggesting that physicians play a role in opioid use rates. At the same time, these prescribing patterns are likely to be exogenous with respect to unobserved workers’ characteristics. We examine the relationship between opioids and return to work using a sample of low-back pain injuries. For these injuries we have developed measures of severity that provide another set of controls not used in prior studies. When we examine whether a worker had any opioids prescriptions – without regard to the duration of opioid use – we find no relationship between opioids prescriptions and duration of temporary disability. However, we find that longer-term use of opioids leads to longer duration of temporary disability benefits.Prescription Drug Monitoring Programs: The Role of Asymmetric Information on Drug Availability and Abuse
Abstract
The diversion of controlled prescription drugs can arise through "doctor shopping," where a patient obtains multiple prescriptions from differenthealthcare 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% and 11%, respectively. In turn, prescription opioid and benzodiazepine deaths decreased by 9% and 13%, respectively. I also find evidence, albeit weak, suggesting that illegal drug deaths increased.
JEL Classifications
- I0 - General