When Treatment Misses Need: Marketing and the Misallocation of Opioid Care

Abstract

There is growing recognition that marketing can create social benefits for consumers as well as economic benefits for firms and communities; and while it can expand access to health promoting products, it can also reinforce market inequalities if misaligned with public need. We study this tension against the backdrop of the US opioid crisis during a time in which medications for opioid use disorder (OUD) were widely available. We link opioid shipments, overdose mortality, media and trade promotion, and healthcare access measures from multiple stakeholders to examine whether marketing mix variables direct OUD treatment toward areas with greater need. We find substantial geographic mismatch, with local retail pharmacies and hospitals/clinics remaining active suppliers for pain opioids. And while treatment supply is positively associated with retail pharmacies and hospital clinics, media and trade promotions only have the same positive effect in counties with high lagged opioid demand. We find that promotions are misaligned in counties with high overdose death burdens and its role in supporting public health treatment is nuanced. The more robust providers of treatment products are distribution through retail outlets and healthcare access at the local level. We include potential implications for a range of stakeholders.

Keywords: opioid crisis, opioid use disorder treatment, pharmaceutical marketing, media advertising, provider-directed promotion, treatment access, supply misallocation