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估算止痛药物需求的价格弹性:来自医疗保险处方药部分的证据。

Estimating price elasticities of demand for pain relief drugs: evidence from Medicare Part D.

机构信息

Department of Health Policy and Management, Fairbanks School of Public Health, Indiana University-Indianapolis, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.

出版信息

Int J Health Econ Manag. 2024 Dec;24(4):481-515. doi: 10.1007/s10754-024-09382-3. Epub 2024 Aug 2.

DOI:10.1007/s10754-024-09382-3
PMID:39093341
Abstract

Overdose deaths from prescription opioids remain elevated, and policymakers seek solutions to curb opioid misuse. Recent proposals call for price-based solutions, such as opioid taxes and removal of opioids from insurance formularies. However, there is limited evidence on how opioid consumption responds to price stimuli. This study addresses that gap by estimating the effects of prices on the utilization of opioids, as well as other prescription painkillers. I use nationally representative individual-level data on prescription drug purchases and exploit the introduction of Medicare Part D in 2006 as an exogenous change in out-of-pocket drug prices. I find that new users have a relatively high price elasticity of demand for prescription opioids, and that consumers treat over-the-counter painkillers as substitutes for prescription painkillers. My results suggest that increasing out-of-pocket prices of opioids, through formulary design or taxes, may be effective in reducing new opioid use.

摘要

处方阿片类药物过量死亡人数仍然居高不下,政策制定者正在寻找解决方案以遏制阿片类药物滥用。最近的提案呼吁采取基于价格的解决方案,例如对阿片类药物征税和将阿片类药物从保险处方集删除。然而,关于阿片类药物消费如何对价格刺激做出反应的证据有限。本研究通过估计价格对阿片类药物以及其他处方止痛药的使用的影响来填补这一空白。我使用了关于处方药购买的全国代表性个人层面数据,并利用 2006 年医疗保险 D 部分的推出作为外生的自付药品价格变化。我发现新用户对处方阿片类药物的需求具有相对较高的价格弹性,并且消费者将非处方止痛药视为处方止痛药的替代品。我的结果表明,通过处方设计或征税来提高阿片类药物的自付价格可能有助于减少新的阿片类药物使用。

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本文引用的文献

1
A National Opioid Tax for Treatment Programs in the US: Funding Opportunity But Problems Ahead.美国针对治疗项目的国家阿片类药物税:资金筹集机遇,但前路仍有问题。
JAMA Health Forum. 2022 Jan 4;3(1):e214316. doi: 10.1001/jamahealthforum.2021.4316.
2
Can policy affect initiation of addictive substance use? Evidence from opioid prescribing.政策会影响成瘾物质的使用初始吗?来自阿片类药物处方的证据。
J Health Econ. 2021 Mar;76:102397. doi: 10.1016/j.jhealeco.2020.102397. Epub 2020 Dec 13.
3
Must-access prescription drug monitoring programs and the opioid overdose epidemic: The unintended consequences.
必须访问的处方药物监测计划与阿片类药物过量流行:意料之外的后果。
J Health Econ. 2021 Jan;75:102408. doi: 10.1016/j.jhealeco.2020.102408. Epub 2020 Nov 26.
4
How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D.增加阿片类药物的医疗可及性如何导致阿片类药物流行:来自医疗保险处方药部分的证据。
J Health Econ. 2020 May;71:102286. doi: 10.1016/j.jhealeco.2019.102286. Epub 2020 Mar 4.
5
Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse.强制性访问处方药物监测计划与处方药物滥用
J Policy Anal Manage. 2019;38(1):181-209.
6
Private provision of social insurance: drug-specific price elasticities and cost sharing in Medicare Part D.社会保险的私人供给:医疗保险D部分中特定药品的价格弹性与成本分担
Am Econ J Econ Policy. 2018 Aug;10(3):122-153. doi: 10.1257/pol.20160355.
7
The Effect of Medicare Part D on Pharmaceutical Prices and Utilization.医疗保险处方药计划(Medicare Part D)对药品价格和使用的影响。
Am Econ Rev. 2010 Mar;100(1):590-607. doi: 10.1257/aer.100.1.590.
8
Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial.单剂量口服阿片类和非阿片类镇痛药对急诊科急性肢体疼痛的影响:一项随机临床试验
JAMA. 2017 Nov 7;318(17):1661-1667. doi: 10.1001/jama.2017.16190.
9
New Persistent Opioid Use Among Patients With Cancer After Curative-Intent Surgery.根治性手术后癌症患者新出现的持续性阿片类药物使用情况
J Clin Oncol. 2017 Dec 20;35(36):4042-4049. doi: 10.1200/JCO.2017.74.1363. Epub 2017 Oct 19.
10
State prescription drug monitoring programs and fatal drug overdoses.州处方药监测计划与药物过量致死
Am J Manag Care. 2017 May;23(5):297-303.