Pharmaceutical Opioid Marketing and Physician Prescribing Behavior Svetlana N. Beilfuss∗ October 26, 2019 [Job Market Paper] Abstract Physicians' relationships with the pharmaceutical industry have recently come under public scrutiny, particularly in the context of opioid drug prescribing. This study examines the effect of doctor-industry marketing interactions on subsequent prescribing patterns of opioids using linked Medicare Part D and Open Payments data for the years 2014-2017. Results indicate that both the number and the dollar- value of marketing visits increase physicians' patented opioid claims. Furthermore, direct-to-physician marketing of safer abuse-deterrent formulations of opioids is the primary driver of positive and persistent spillovers on the prescribing of less safe generic opioids - a result that may be driven by insurance coverage policies. These findings suggest that pharmaceutical marketing efforts may have unintended public health implications. Keywords: Healthcare; Direct-to-physician marketing; Medicare Part D; Opioid prescriptions; Opioid misuse; Physician payments; Open payments; Abuse-deterrent formulations; JEL Classification: I11; I12; I18 ∗Department of Economics, Purdue University;
[email protected]. Please check my website at www.svetlanabeilfuss.com for an up-to-date version of the draft. 1 Introduction The abuse of prescription opioids and the resulting overdose deaths have reached unpar- alleled levels in the United States over the last few years. In 2016, 63,632 individuals died from drug overdoses, with 66.4% of the cases involving opioids. Among opioid-related deaths, 40.4% involved prescription opioids (Centers for Disease Control and Prevention, 2018). Furthermore, two million people in the United States suffer from opioid addiction due to prescription opioid drugs (Schuchat et al., 2017).