Impact of a physician-targeted letter on opioid prescribing

Iiro Ahomäki; Visa Pitkänen; Aarni Soppi; Leena Saastamoinen

doi:10.1016/j.jhealeco.2020.102344

Impact of a physician-targeted letter on opioid prescribing

J Health Econ. 2020 Jul:72:102344. doi: 10.1016/j.jhealeco.2020.102344. Epub 2020 Jun 2.

Authors

Iiro Ahomäki¹, Visa Pitkänen², Aarni Soppi², Leena Saastamoinen²

Affiliations

¹ School of Business and Economics, University of Jyväskylä, PO Box 35, FI-40014, Finland. Electronic address: iiro.l.j.ahomaki@jyu.fi.
² Social Insurance Institution of Finland, Finland.

PMID: 32592925
DOI: 10.1016/j.jhealeco.2020.102344

Abstract

We study the effect of a physician-targeted nudge letter on opioid prescribing. In May 2017, the Social Insurance Institution of Finland sent a personal information letter to all physicians who had issued a prescription containing at least 100 tablets of paracetamol-codeine combination to a new patient. The aim of the letter was to draw the physicians' attention to their prescribing practices and to decrease the size of the first codeine prescription. Using individual level register data and a difference-in-differences strategy, we estimate that the letter decreased the average number of tablets purchased by new patients by 12.5 percent and the probability of a first purchase being at least 100 tablets by six percentage points. We also find that these effects were larger among consistent high prescribers. However, we do not find similar effects on other mild or strong opioids.

Keywords: Difference-in-differences; Information letter; Opioid prescribing; Prescription drugs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid*
Finland
Humans
Physicians*
Practice Patterns, Physicians'

Substances

Analgesics, Opioid