Do State Regulations Restricting Prescriptions of Opioids Affect Provider-Pharma Financial Ties? Evidence from Open Payments Data

Federal Open Payments data show that since August of 2013 through the end of 2016, US physicians explicitly received approximately $8 billion per year from drug and medical device manufacturers in various forms of research payments, investment interest, industry-sponsored meals, payments for education and training, consulting fees, travel and lodging, and entertainment. Prior studies have confirmed positive associations between these payments and rates of brand-name drug prescriptions (for instance, Yeh et al. 2016). The provider-pharma financial ties may also affect opioid prescribing practices, which have been a considerable focus of recent state regulatory changes. This paper utilizes the federal Open Payments database (2013-2016, although some of our data start in 2009) to investigate the impact of key state laws enacted to regulate opioid prescription practices, on provider-pharma financial ties. State laws of interest include state prescription drug monitoring programs, pill mill laws, and physical examination requirements, among others. This study aims to shed light on economic predictions of how regulations that reduce product demand could reduce promotional activities by industry. More specific to policy, this study examines potential conflicts of interest that could interfere with physicians’ responsibilities to their patients, and to the US public health efforts to combat the opioid epidemic.