The Saliency of Prescription Drug Monitoring Programs on Patients By Insurer Type

In response to climbing opioid abuse and overdoses, states passed several types of programs that target the supply side of the prescription opioid market, including Prescription Drug Monitoring Programs (PDMPs) which track patient histories, mandates that doctors use the programs, ``Pill Mill Bills" that target over-prescribing offices, and abuse-deterrent versions of prescription opioids. This paper is the first to investigate the effects of these policies on opioid-related business establishment counts nationwide, and examines how the policies affect rehabilitation facilities, doctors' offices and clinics, and pharmacies. I find that Pill Mill crackdowns reduce the number of establishments in a widely-defined category which includes pain management clinics. States that implement the Pill Mill Bills notice a statistically significant 6-7% reduction in the rate of clinics per capita in this category. The Pill Mill Bills are associated with fewer pharmacies, a 2.6% decrease, but this result is only statistically significant within counties that receive a high concentration of opioids. ``Must Access" mandates are associated with a 1.5-2.5% rise in the rate of residential rehabilitation establishments. The policies are not found to significantly affect inpatient rehabilitation hospitals, outpatient rehabilitation clinics, doctors' offices, medical labs, or drug wholesalers. While the effect of opioid policies on patient and physician behavior has been well-investigated, this paper provides evidence that policies have spillover effects on medical business establishments.