Date of Award
Doctor of Philosophy (PhD)
Opioid abuse is currently the most significant public health problem in the US. Many US
states have implemented prescription drug monitoring programs (PDMPs) in response. In
the rst paper, I use a new micro-level medical claims database to exploit state-level and
time-series variations in PDMP implementation and shed light on the impacts of these
programs. My results show that PDMPs have led to an overall 14% reduction in the odds
ratio of abuse/addiction. Also, there is evidence of substantial heterogeneity in impacts,
with larger impacts for females and minorities. Another nding is that at least 23% of
opioid abuse is a result of drug diversion to nonmedical opioid users. PDMPs were not
successful in decreasing the rate of abuse for this group, and, in fact, there is some
evidence that they increased the diversion to heroin. Finally, I show that PDMPs'
eectiveness varies by type of insurance and that they are more eective in reducing abuse
rates in the general population as compared with Medicare Part D recipients. I use my
estimates to analyze the potential eects of modifying PDMPs to include giving insurance
providers access to electronic databases, providing educational programs for less-educated
people, and expanding their \must access" requirement. In the second chapter, I estimate
dierent models for opioid demand and compare their performance. My results suggest
that the NB2 and Poisson FE models best match the data. Using these models for
calculating the marginal effect of insurance characteristics provides suggestive evidence of
the best insurance design to reduce the demand for opioids.
Mohammadi, Zahra, "Essays In Health Economics" (2018). Publicly Accessible Penn Dissertations. 2874.