Journal of health economics
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Although supply-side drug policies that limit access to legal opioids have reduced prescription opioid abuse, growing evidence shows that these policies have had the unintended consequence of increasing use of illegal opioids, including heroin. I add to this literature by studying the consequences of must-access prescription drug monitoring programs (PDMPs), which legally require providers to access a state-level database with a patient's prescription history before prescribing controlled substances under certain circumstances. ⋯ My estimates indicate that two years after implementation, must-access PDMPs were associated with 0.9 more heroin deaths per 100,000 in a half-year period, relative to control states. My results suggest that even if must-access PDMPs reduce prescription opioid deaths, the decrease is offset by a large increase in illegal opioid deaths.
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Minimum unit prices (MUPs) have been proposed on the grounds that they can reduce alcohol consumption of the heaviest drinkers, without significantly burdening moderate drinkers. This paper examines the case for MUPs in an optimal tax framework. Such a policy can improve welfare when two conditions are both satisfied. ⋯ Second, there should be more distortion to consumption of cheaper alcohol than to more expensive varieties. The consequences of a MUP for the optimal corrective tax are explored with a calibrated numerical example. This example illustrates how the optimal tax rate might be higher when used in isolation, than when a MUP is also being used.
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We use the Nielsen Consumer Panel to investigate the impact of tobacco control policies on purchases of electronic cigarettes (e-cigarettes), cigarettes, and smoking cessation products. We measure product quantity, product type, nicotine content, and liquid volume of e-cigarettes, and product quantity and nicotine content of cigarettes. Higher cigarette excise taxes decrease both cigarette and e-cigarette purchases, suggesting that cigarettes and e-cigarettes are complements, and higher cigarette excise taxes reduce the aggregate amount of nicotine purchased from cigarettes and e-cigarettes. Cigarette smoke-free air laws decrease cigarette purchases, while e-cigarette smoke-free air laws do not affect cigarette or e-cigarette purchases.
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Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths. We replicate the result for opioid overdose deaths and explore the potential mechanism. ⋯ As states have become more stringent in their regulation of dispensaries, the protective value generally has fallen. These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.
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Many competitive health insurance markets adjust payments to participating health plans according to their enrollees' risk - including based on diagnostic information. We investigate responses of German health plans to the introduction of morbidity-based risk adjustment in the Statutory Health Insurance in 2009, which triggers payments based on "validated" diagnoses by providers. ⋯ This increase appears to originate from both a shift from not-validated toward validated diagnoses and an increase in the number of such diagnoses. Overall, our results indicate that plans were successful in influencing physicians' coding practices in a way that could lead to higher payments.