Analysis of pharmaceutical detailing records from 2014-2018 found only weak evidence that medical cannabis laws reduced drug company marketing to physicians, with any effects small and delayed.
Health economists, pharmaceutical industry analysts, and cannabis policy researchers.
Medical cannabis laws produced only weak, economically small effects on pharma marketing
What the researchers found
Medical cannabis law enactment was associated with weak evidence of small, delayed reductions in pharmaceutical detailing for substitute prescription drugs and opioids. Effects were slightly more pronounced among smaller pharmaceutical firms. However, the magnitudes were economically small, likely because only a small percentage of doctors actively recommend cannabis for medical treatment.
Why it matters
If medical cannabis truly substitutes for prescription drugs, pharmaceutical companies should reduce marketing in response. The finding of minimal marketing response suggests either that cannabis substitution is limited in practice or that pharma companies do not perceive cannabis as a serious market threat.
The numbers in context
Data from 2014-2018 county-level detailing records. Weak evidence of reduced detailing for substitute drugs and opioids. Larger effects in smaller firms. Magnitudes economically small.
How the study worked
Exploited geographic and temporal variation in medical cannabis laws across US states. Used office detailing records from 2014-2018 aggregated to the county level. Examined changes in direct-to-physician marketing by pharmaceutical firms following MCL enactment.
What this study cannot tell us
Observational with county-level aggregation. Cannot directly measure prescription substitution. Detailing records may not capture all marketing channels. 2014-2018 period captures early MCL effects only.
How to read the evidence
Novel dataset with appropriate econometric methods. Limited by indirect measurement of cannabis substitution effects.
When this study was published
2021 study using 2014-2018 pharmaceutical detailing data.
The bigger picture
The muted pharmaceutical marketing response to cannabis laws contrasts with survey data showing patients self-reporting large-scale prescription substitution. This disconnect suggests that at the population level, medical cannabis may not yet be shifting prescription drug markets as dramatically as individual surveys suggest.
Questions still open
- Would recreational legalization produce larger marketing responses? Are pharmaceutical companies underestimating cannabis competition? Would longer follow-up periods reveal larger effects?
Common questions
Did medical cannabis laws change how drug companies market to doctors?
Why was the response so small?
Read the original research
The effect of medical cannabis laws on pharmaceutical marketing to physicians.
Health economics, 30(10), 2409-2436
Citation
Lebesmuehlbacher, Thomas; Smith, Rhet A. (2021). The effect of medical cannabis laws on pharmaceutical marketing to physicians.. Health economics, 30(10), 2409-2436. https://doi.org/10.1002/hec.4380