Panel Paper: The Saliency of Pdmps and Their Mandates: A Cross-Population Investigation into Heterogeneous Monitoring

Saturday, November 9, 2019
I.M Pei Tower: Majestic Level, Vail (Sheraton Denver Downtown)

*Names in bold indicate Presenter

Justine Mallatt, Bureau of Economic Analysis

PDMPs are seen as an essential tool for reducing the supply of prescription opioids to those who would abuse them, but studies examining their effectiveness in reducing opioid prescriptions and adverse health outcomes have yielded inconsistent and mixed results. This paper seeks to align and reconcile conflicting findings in the literature by analyzing the impact that both optional-access and mandatory-access PDMPs have on different insured populations in the US-- the widely-studied Medicare population, the less-studied employer insured population, and the rarely-examined Medicaid population. I find evidence that optional-access PDMPs affect opioid amounts and abuse outcomes in the Medicaid population, mandatory-access PDMPs sharply reduce opioid amounts and abuse outcomes within those enrolled in Medicare Part D (consistent with findings in Carey and Buchmueller 2018), and there is not strong or consistent evidence that either optional-access or mandatory-access PDMPs affect the employer insured population. Further investigation into the Medicaid population shows that optional-access PDMPs have a larger impact among patients with high past levels of opioid prescriptions. The Medicaid population is disproportionately composed of individuals with substance abuse and chronic pain; this demographic difference may explain why optional-access PDMPs are more salient among this population.