How Do "Must-Access" Prescription Drug Monitoring Programs Address Opioid Misuse?

The opioid epidemic led to the creation of state Prescription Drug Monitoring Programs (PDMPs) that eventually mandated access. We examine how these "must-access" PDMPs influenced prescribing after an emergency department (ED) visit and in the long term for the working-age population. By using data from a large multistate commercial insurance database from 2010 to 2014 and estimating difference-in-differences models, we show that only the broadest must-access PDMPs reduced opioid prescribing after an ED visit and in the long term. We then compared changes in prescribing rates for opioid naive relative to non-opioid naive individuals to disentangle the influence of information from administration costs on prescriber behavior. Findings suggest that hassle cost explains the majority of the decline in initial prescribing, and that the information value drives most of the reduction in long-term outcomes.