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The OxyContin Reformulation Revisited: New Evidence From Improved Definitions of Markets and Substitutes

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  • Shiyu Zhang
  • Daniel Guth

Abstract

The opioid epidemic began with prescription pain relievers. In 2010 Purdue Pharma reformulated OxyContin to make it more difficult to abuse. OxyContin misuse fell dramatically, and concurrently heroin deaths began to rise. Previous research overlooked generic oxycodone and argued that the reformulation induced OxyContin users to switch directly to heroin. Using a novel and fine-grained source of all oxycodone sales from 2006-2014, we show that the reformulation led users to substitute from OxyContin to generic oxycodone, and the reformulation had no overall impact on opioid or heroin mortality. In fact, generic oxycodone, instead of OxyContin, was the driving factor in the transition to heroin. Finally, we show that by omitting generic oxycodone we recover the results of the literature. These findings highlight the important role generic oxycodone played in the opioid epidemic and the limited effectiveness of a partial supply-side intervention.

Suggested Citation

  • Shiyu Zhang & Daniel Guth, 2021. "The OxyContin Reformulation Revisited: New Evidence From Improved Definitions of Markets and Substitutes," Papers 2101.01128, arXiv.org, revised Jan 2021.
    • Handle: RePEc:arx:papers:2101.01128
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    1. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2017. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," NBER Working Papers 23031, National Bureau of Economic Research, Inc.
    2. 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.
    3. Sarah DeWeerdt, 2019. "Tracing the US opioid crisis to its roots," Nature, Nature, vol. 573(7773), pages 10-12, September.
    4. Carpenter, Christopher S. & McClellan, Chandler B. & Rees, Daniel I., 2017. "Economic conditions, illicit drug use, and substance use disorders in the United States," Journal of Health Economics, Elsevier, vol. 52(C), pages 63-73.
    5. Van Zee, A., 2009. "The promotion and marketing of oxycontin: Commercial triumph, public health tragedy," American Journal of Public Health, American Public Health Association, vol. 99(2), pages 221-227.
    6. 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.
    7. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 1-37.
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