The role of pharmaceutical promotion in the opioid epidemic in the US
Fernando Fernandez et Dijana Zejcirovic
February 15th 2019, 12.30 – 13.45
Salle Bilsky Pasquier, Hôtel-Dieu,
1 Parvis de Notre Dame, 75004 Paris
Mortality rates of drug overdose have nearly quadrupled since 1999. This sharp increase has been so vast that overall mortality rates (all causes of death) among non-Hispanic whites have risen over recent years, reversing a long-run decreasing trend in previous decades. Opioid drugs, painkillers more powerful than morphine and as addictive as heroin, account for forty percent of all overdose deaths. The sales of these drugs skyrocketed in the last two decades as their perceived safety increased after aggressive marketing campaigns of opioid companies.
We study the effects of opioid pharmaceutical marketing delivered to physicians on opioid-related overdose deaths. Using data on links between sales representatives of opioid drugs and physicians, we show that counties with higher opioid promotion delivered to doctors also have higher opioid overdose deaths. The identification of these effects relies on the presence of state-level bans on pharmaceutical marketing and variation in the distance between counties and the headquarters of opioid companies. Additional evidence from prescription data reveals that doctors receiving opioid promotion increase their prescription rates of such drugs.
Other research interests: « Prenatal Exposure to Marijuana and Infant Health in the US »
In the US, the number of state governments that legalized cannabis for medical purposes proliferated over the last decade. This rapid expansion in marijuana availability has been accompanied by growing concerns from public health authorities.
This study evaluates the consequences of increased marijuana availability on infant health. Unlike previous studies that exploit policy changes at the state-level, I collected novel data on the precise location and opening date of every cannabis dispensary (legal point of sale) in the country to create county-specific measures of increased marijuana availability. Combining this information with data on birth outcomes, I show that higher prenatal cannabis exposure is unrelated to changes in several indicators of infant health, once I control for county fixed-effects and state-specific trends. Additional evidence from an event-study framework with similar controls also reveals that increased in-utero exposure to cannabis is unrelated to various infant health indicators.
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