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The Problem of Data Quality in Analyses of Opioid Regulation: The Case of Prescription Drug Monitoring Programs

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  • Jill Horwitz
  • Corey S. Davis
  • Lynn S. McClelland
  • Rebecca S. Fordon
  • Ellen Meara

Abstract

States, which have the primary legal role in regulating the prescribing and dispensing of prescription medications, have created Prescription Drug Monitoring Programs (PDMP) to try to reduce inappropriate prescribing, dispensing, and related harm. Research assessing whether these interventions are effective has produced inconclusive and contradictory results. Here we examine whether different data sources may have contributed to the varying results. Specifically, we: 1) identify the decisions inherent in creating such a dataset; 2) discuss the public data sources used by researchers in previous work; 3) develop and apply a detailed research protocol to create a novel PDMP law dataset; and 4) to illustrate potential consequences of data choice, apply various data sources to analyze the relationship between PDMP laws and prescribing and dispensing of opioids among disabled Medicare beneficiaries. We find that our dates differ from those in existing datasets, sometimes by many years. The regression analyses generated a twofold difference in point estimates, as well as different signed estimates, depending on the data used. We conclude that the lack of transparency about data assembly in existing datasets, differences among dates by source, and the regression results raise concerns for PDMP researchers and policymakers.

Suggested Citation

  • Jill Horwitz & Corey S. Davis & Lynn S. McClelland & Rebecca S. Fordon & Ellen Meara, 2018. "The Problem of Data Quality in Analyses of Opioid Regulation: The Case of Prescription Drug Monitoring Programs," NBER Working Papers 24947, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:24947
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    1. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    2. Rebecca M. Blank, 2002. "Evaluating Welfare Reform in the United States," Journal of Economic Literature, American Economic Association, vol. 40(4), pages 1105-1166, December.
    3. Davis, C.S. & Pierce, M. & Dasgupta, N., 2014. "Evolution and convergence of state laws governing controlled substance prescription monitoring programs, 1998-2011," American Journal of Public Health, American Public Health Association, vol. 104(8), pages 1389-1395.
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    2. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    3. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2020. "Prescription drug monitoring programs and neonatal outcomes," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    4. Aliprantis, Dionissi & Fee, Kyle & Schweitzer, Mark E., 2023. "Opioids and the labor market," Labour Economics, Elsevier, vol. 85(C).
    5. Christopher J. Ruhm, 2019. "Shackling the Identification Police?," Southern Economic Journal, John Wiley & Sons, vol. 85(4), pages 1016-1026, April.
    6. Claudio Deiana & Ludovica Giua & Roberto Nisticò, 2024. "Opium Price Shocks and Prescription Opioids in the USA," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 86(3), pages 449-484, June.
    7. Dhaval Dave & Monica Deza & Brady Horn, 2021. "Prescription drug monitoring programs, opioid abuse, and crime," Southern Economic Journal, John Wiley & Sons, vol. 87(3), pages 808-848, January.
    8. Orgul Ozturk & Yuan Hong & Suzanne McDermott & Margaret Turk, 2021. "Prescription Drug Monitoring Programs and Opioid Prescriptions for Disability Conditions," Applied Health Economics and Health Policy, Springer, vol. 19(3), pages 415-428, May.
    9. Graham, Francis W. & de New, Sonja C. & Nielsen, Suzanne & Petrie, Dennis, 2023. "Revisiting the OxyContin Reformulation: The Role of Licit Substitutes," IZA Discussion Papers 16653, Institute of Labor Economics (IZA).
    10. Deiana Claudio & Giua Ludovica, 2021. "The Intended and Unintended Effects of Opioid Policies on Prescription Opioids and Crime," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(2), pages 751-792, April.
    11. 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, John Wiley & Sons, Ltd., vol. 29(9), pages 957-974, September.
    12. Lucy Xiaolu Wang, 2021. "The complementarity of drug monitoring programs and health IT for reducing opioid‐related mortality and morbidity," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2026-2046, September.
    13. Ericson, Keith Marzilli & Sacarny, Adam & Zhou, Annetta, 2023. "Dangerous prescribing and healthcare fragmentation: Evidence from opioids," Journal of Public Economics, Elsevier, vol. 225(C).
    14. Lindsey Rose Bullinger & Benjamin C. Ward, 2021. "What about the children? How opioid use affects child well‐being," Contemporary Economic Policy, Western Economic Association International, vol. 39(4), pages 737-759, October.
    15. Kaestner, Robert & Ziedan, Engy, 2023. "Effects of prescription opioids on employment, earnings, marriage, disability and mortality: Evidence from state opioid control policies," Labour Economics, Elsevier, vol. 82(C).
    16. David Cho & Alvaro Mezza & Joshua Montes, 2022. "Choices and Implications when Measuring the Local Supply of Prescription Opioids," Finance and Economics Discussion Series 2022-078, Board of Governors of the Federal Reserve System (U.S.).
    17. Shishir Shakya & Collin Hodges, 2023. "Must‐access prescription drug monitoring programs and retail opioid sales," Contemporary Economic Policy, Western Economic Association International, vol. 41(1), pages 146-165, January.
    18. Kim, Bokyung, 2021. "Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences," Journal of Health Economics, Elsevier, vol. 75(C).
    19. Gal Wettstein, 2019. "Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 666-677, May.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law
    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law

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