How Well Do Doctors Know Their Patients? Evidence from a Mandatory Access Prescription Drug Monitoring Program
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.
The authors are grateful to David Hopkins and Adam Berrones from KASPER and Amanda Garrett and Kara Slusser from INSPECT for assistance in accessing the data and understanding the details of the Prescription Drug Monitoring Programs in Kentucky and Indiana. We thank Mike Mei for sharing ARCOS data. Jamie Fogel, Rebecca Haffajee, Bernardo Modenesi, Anita Mukherjee, Edward Norton, Adam Sacarny, and seminar participants at University of Michigan provided helpful comments. The authors have no conflicts of interest to disclose. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Thomas C. Buchmueller & Colleen M. Carey & Giacomo Meille, 2020. "How well do doctors know their patients? Evidence from a mandatory access prescription drug monitoring program," Health Economics, vol 29(9), pages 957-974.