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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Farasat Bokhari, PhD, School of Public Health, University of California, Berkeley, 140 Warren Hall, MC 7360, Berkeley, CA 94720, 510-642-5659, bokhari@socrates.berkeley.edu, Rick Mayes, PhD, Department of Political Science, University of Richmond, 28 Westhampton Way, University of Richmond, Richmond, VA 23173, and Richard Scheffler, PhD, School of Public Health, UC Berkeley, 120 Warren Hall, Berkeley, CA 94611.
Background: Roughly one in every 15-20 school-age children in the U.S. has Attention Deficit Hyperactivity Disorder (ADHD), while one in 20-25 regularly use psychostimulants to treat the disorder. Use of these drugs varies considerably, 3-fold across states and 10-fold within states. Our research provides an economic and policy analysis of variation in psychostimulant use for ADHD. We employ a market-level model to test hypotheses regarding the effect of social, economic, demographic (age, sex, race, ethnicity), state regulatory, school policy, health system, and other educational variables on the supply and demand for psychostimulants. Specifically, we investigate which factors affect the demand and supply of these drugs, how they determine the consumption rates, and which ones are relatively more important? We also compute the price and income elasticity of demand for the drugs.
Methodology: Specify a structural market model for the consumption of psychostimulants (methylphenidate and amphetamine) and formally test the hypotheses regarding the effect of social, economic and demographic variables, as well as specific state legislation and education policies, on the demand and supply for these drugs. We use data on consumption rates, price and instruments for the price of the drug (i.e., number of pharmacies per capita, presence of “any willing provider” and “freedom of choice” laws between HMOs and pharmacies) to identify the structural coefficients from reduced form estimates. Both single equation (2SLS/IV) and system estimators (3SLS/GMM) are employed.
Data: The two primary sources of data are (i) DEA data which provides the distribution of methylphenidate and amphetamine in grams down to the 5 digit zip code-level from 1997 onwards (currently up to 2000 is available); and (ii) the total sales (revenue) and quantity dispensed of methylphenidate and amphetamine from all pharmacies in a zip code from 1998 onwards. A county and HSA level panel data set is constructed for the years 1998-2002. Average price measures are constructed from the revenues and quantities figures (sales/quantity) within each market. The remaining variables are obtained from various sources. These include: Area Resource Files (ARF), Census Estimates, InterStudy Publications, and information on state regulations compiled from various published sources. The school and education related variables are obtained from the Common Core of Data, the Education Week "Quality Counts," and Consortium for Policy Research in Education. The analysis presented at this conference will include results from a two-year panel (1998 and 1999) based on the data currently available to us.
Learning Objectives:
Keywords: Drug Use Variation, Adult and Child Mental Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.