Information Gains versus Hassle Costs: How Do Prescription Drug Monitoring Programs Reduce Opioid Prescribing?
Abstract: In the U.S., opioid overdoses, abuse and diversion have increased dramatically over the last two decades creating an unprecedented public health crisis. Interventions targeted at physician prescribing may play an important role in reducing opioid abuse. In this project, we will study the consequences of one of the most widely adopted physician interventions– Prescription Drug Monitoring Programs (PDMPs). While PDMP use is optional in many states, we focus on several states that implemented PDMP mandates which require doctors to query the patient’s prescription history through the PDMP before prescribing controlled substances. Previous studies have examined the aggregate effects of PDMP mandates at the state-level, finding substantial reductions in opioid prescriptions, however, little is known about the underlying mechanisms through which PDMPs impact prescribing behaviors. PDMPs may decrease prescribing to patients suspected of misuse when information on opioid prescription histories is made available. On the other hand, PDMPs may lower the rate of opioid prescribing to all patients—even those who would benefit from treatment—through the introduction of an additional hurdle to writing an opioid prescription. Using detailed individual-level claims data from OptumInsight, this project aims to isolate the extent to which prescribing reductions from PDMPs are due to gains in information versus hassle costs and the long-term consequences of these prescribing changes.