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Competitive effects of federal and state opioid restrictions: Evidence from the controlled substance laws

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  • Gupta, Sumedha
  • Nguyen, Thuy
  • Freeman, Patricia R.
  • Simon, Kosali

Abstract

A significant concern in the policy landscape of the U.S. opioid crisis is whether supply-side controls can reduce opioid prescribing without harmful substitution. We consider an unstudied policy: the federal Controlled Substance Act (CSA) restrictions placed in August 2014 on tramadol, the second most popular opioid medication. This was followed seven weeks later by CSA restrictions for hydrocodone combination products, the leading opioids on the market. Using regression discontinuity design (RDD) models, based on the timing of the (up-)scheduling changes, to explore spillover effects, we find that tightening prescribing restrictions on one opioid reduces its use, but increases prescribing of close competitors, leading to no reduction in total opioid prescriptions.This suggests that supply restrictions are not effective in reducing opioid prescribing the presence of close substitutes that remain unrestricted.

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  • Gupta, Sumedha & Nguyen, Thuy & Freeman, Patricia R. & Simon, Kosali, 2023. "Competitive effects of federal and state opioid restrictions: Evidence from the controlled substance laws," Journal of Health Economics, Elsevier, vol. 91(C).
    • Handle: RePEc:eee:jhecon:v:91:y:2023:i:c:s0167629623000498
    DOI: 10.1016/j.jhealeco.2023.102772
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    1. Meltem Daysal N. & Orsini Chiara, 2015. "Spillover Effects of Drug Safety Warnings on Preventive Health Care Use," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 15(1), pages 179-208, January.
    2. Chantal Toledo & Sofia Berto Villas-Boas, 2019. "Safe or Not? Consumer Responses to Recalls with Traceability," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 41(3), pages 519-541, September.
    3. Hollingsworth, Alex & Ruhm, Christopher J. & Simon, Kosali, 2017. "Macroeconomic conditions and opioid abuse," Journal of Health Economics, Elsevier, vol. 56(C), pages 222-233.
    4. 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.
    5. John Romley & Tiffany Shih, 2017. "Product safety spillovers and market viability for biologic drugs," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 135-158, June.
    6. Thuy D. Nguyen & W. David Bradford & Kosali I. Simon, 2019. "How do Opioid Prescribing Restrictions Affect Pharmaceutical Promotion? Lessons from the Mandatory Access Prescription Drug Monitoring Programs," NBER Working Papers 26356, National Bureau of Economic Research, Inc.
    7. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2018. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 1-35, November.
    8. Kristy Parkinson & Joseph Price & Kosali Simon & Sharon Tennyson, 2014. "The influence of FDA advisory information and black box warnings on individual use of prescription antidepressants," Review of Economics of the Household, Springer, vol. 12(4), pages 771-790, December.
    9. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    10. Catherine Hausman & David S. Rapson, 2018. "Regression Discontinuity in Time: Considerations for Empirical Applications," Annual Review of Resource Economics, Annual Reviews, vol. 10(1), pages 533-552, October.
    11. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, vol. 142(2), pages 698-714, February.
    12. Deiana, Claudio & Giua, Ludovica, 2018. "The US Opidemic: Prescription Opioids, Labour Market Conditions and Crime," MPRA Paper 85712, University Library of Munich, Germany.
    13. Engy Ziedan & Robert Kaestner, 2020. "Effect of Prescription Opioids and Prescription Opioid Control Policies on Infant Health," NBER Working Papers 26749, National Bureau of Economic Research, Inc.
    14. Robert Kaestner & Engy Ziedan, 2019. "Mortality and Socioeconomic Consequences of Prescription Opioids: Evidence from State Policies," NBER Working Papers 26135, National Bureau of Economic Research, Inc.
    15. 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.
    16. Hahn, Jinyong & Todd, Petra & Van der Klaauw, Wilbert, 2001. "Identification and Estimation of Treatment Effects with a Regression-Discontinuity Design," Econometrica, Econometric Society, vol. 69(1), pages 201-209, January.
    17. Seth Freedman & Melissa Kearney & Mara Lederman, 2012. "Product Recalls, Imperfect Information, and Spillover Effects: Lessons from the Consumer Response to the 2007 Toy Recalls," The Review of Economics and Statistics, MIT Press, vol. 94(2), pages 499-516, May.
    18. Bütikofer, Aline & Cronin, Christopher J. & Skira, Meghan M., 2020. "Employment effects of healthcare policy: Evidence from the 2007 FDA black box warning on antidepressants," Journal of Health Economics, Elsevier, vol. 73(C).
    19. Sacks, Daniel W. & Hollingsworth, Alex & Nguyen, Thuy & Simon, Kosali, 2021. "Can policy affect initiation of addictive substance use? Evidence from opioid prescribing," Journal of Health Economics, Elsevier, vol. 76(C).
    20. Collins, J. Michael & Simon, Kosali I. & Tennyson, Sharon, 2013. "Drug withdrawals and the utilization of therapeutic substitutes: The case of Vioxx," Journal of Economic Behavior & Organization, Elsevier, vol. 86(C), pages 148-168.
    21. Ioana Popovici & Johanna Catherine Maclean & Bushra Hijazi & Sharmini Radakrishnan, 2018. "The effect of state laws designed to prevent nonmedical prescription opioid use on overdose deaths and treatment," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 294-305, February.
    22. Abby E. Alpert & Sarah E. Dykstra & Mireille Jacobson, 2020. "How Do Prescription Drug Monitoring Programs Reduce Opioid Prescribing? The Role of Hassle Costs versus Information," NBER Working Papers 27584, National Bureau of Economic Research, Inc.
    23. 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.
    24. Ram Bala & Pradeep Bhardwaj & Pradeep K. Chintagunta, 2017. "Pharmaceutical Product Recalls: Category Effects and Competitor Response," Marketing Science, INFORMS, vol. 36(6), pages 931-943, November.
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    Cited by:

    1. Alexander Ahammer & Analisa Packham, 2024. "Supply-Side Drug Policy, Polydrug Use, and the Economic Effects of Withdrawal Symptoms," NBER Working Papers 32804, National Bureau of Economic Research, Inc.
    2. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    3. Denis Agniel & Jonathan H. Cantor & Johanna Catherine Maclean & Kosali I. Simon & Erin Taylor, 2023. "Insurance Coverage and Provision of Opioid Treatment: Evidence from Medicare," NBER Working Papers 31884, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    Opioids; Controlled substance act; Prescribing;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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