The Impact of Opioid Manufactures Contributions to Doctors on Opioid-Related Deaths

According to the Centers for Disease Control and Prevention (CDC), the number of opioid prescriptions, as well as the rate of opioid related deaths, have quadrupled since 1999. For decades, pharmaceutical manufactures have had a practice of giving physicians in-kind and monetary gifts. If physicians respond to gifts from opioid manufacturers by prescribing more opioid medications, then rates of misuse, abuse and even death could rise. This issue has not previously been addressed in the literature. I collect data on all non-heroin opioid-related deaths from the National Vital Statistics Multiple Cause-of-Death Mortality Files for the years 2013-2015 and merge it to data on the value of gifts from opioid manufacturers to each physician in the U.S. from the Open Payments dataset. I estimate the association between the value of pharmaceutical gifts flowing to all physicians in a county and the number of county-level opioid deaths using a series of Poisson regression models. Finally, I predict the number of lives that would have been saved in a counterfactual world where doctors were not permitted to receive any pharmaceutical gifts. I find that, had this practice been prohibited, 822 lives would have been saved nationally between 2013 and 2015.