Data from: Co-prescription network reveals social dynamics of opioid doctor shopping

These are deidentified health claims from a large commercially insured population of about 19 million patients for the period of June 2015 through December 2016, covering the states of Georgia, North Carolina, Tennessee, Kentucky, Virginia, and West Virginia. Data are observed quarterly at the patient level and linked across administrative and health data. Patients are demographically representative of the US population with respect to gender and age, and representative of the commercially-insured population on all other measurable characteristics. The analysis sample contains 526,914 patients who contribute 2,107,656 quarterly observations. *Brea L. Perry *Stata code for PLOS ONE PONE-D-19-05832 *Aug 03, 2019 NOTE: zipcode not included in data because of HIPAA privacy regulations use "DATA" recode oud anyod opioidod (.=0) *drop anyone who was never prescribed an opioid in 2016 bysort patid: egen totrx=total(numrx) drop if totrx==0 gen logdegree=ln(degree+1) lab var logdegree "Network degree logged" egen stdpr=std(pagerank) lab var stdpr "Standardized pagerank" fre state drop if state=="PR" | state=="-" tab state, gen(st) *Some patients switched states, so define state as state they lived in longest for purposes of MLM bysort patid: egen numnc=total(st6) bysort patid: egen numga=total(st2) bysort patid: egen numwv=total(st13) bysort patid: egen numky=total(st3) bysort patid: egen numva=total(st12) bysort patid: egen numtn=total(st11) bysort patid: egen numoh=total(st8) egen maxstate=rowmax(numnc-numoh) gen appseven=. replace appseven=1 if maxstate==numwv replace appseven=2 if maxstate==numky replace appseven=3 if maxstate==numva replace appseven=4 if maxstate==numtn replace appseven=5 if maxstate==numoh replace appseven=6 if maxstate==numnc replace appseven=7 if maxstate==numga replace appseven=. if appseven==7 & numga==0 lab def appseven 1 "WV" 2 "KY" 3 "VA" 4 "TN" 5 "OH" 6 "NC" 7 "GA" lab val appseven appseven *Drop patients not in one of these states keep if appseven!=. *Generate city indicator for MLM gen zipshort=int(zipcode/100) egen citygrp=group(zipshort) sum citygrp xtset patid time *Create percentile rank on PageRank *bysort time: egen prpctile2=pctile(pagerank) bysort time: egen prrank=rank(pagerank) bysort time: egen maxrank=max(prrank) gen prpctile=round(prrank/(maxrank/100)) drop maxrank lab var prpctile "Percentile rank in 1% increments" bysort time: egen biprrank=rank(birank) bysort time: egen maxbirank=max(biprrank) gen biprpctile=round(biprrank/(maxbirank/100)) drop maxbirank lab var biprpctile "Percentile bipartite PageRank in 1% increments" bysort patid: egen BPprpct=mean(prpctile) gen WPprpct=prpctile-BPprpct lab var BPprpct "Between Person percentile PageRank" lab var WPprpct "Within Person percentile PageRank" bysort patid: egen BPbiprpct=mean(biprpctile) gen WPbiprpct=biprpctile-BPbiprpct lab var BPbiprpct "Between Person bipartite percentile PageRank" lab var WPbiprpct "Within Person bipartite percentile PageRank" bysort patid: egen BPstdpr=mean(stdpr) gen WPstdpr=stdpr-BPstdpr lab var BPstdpr "Between Person Std PageRank" lab var WPstdpr "Within Person Std PageRank" bysort patid: egen BPlogdegree=mean(logdegree) gen WPlogdegree=logdegree-BPlogdegree lab var BPlogdegree "Between Person logged degree centrality" lab var WPlogdegree "Within Person logged degree centrality" gen inscat=. replace inscat=1 if hmo==0 & pos==0 replace inscat=2 if pos==1 replace inscat=3 if hmo==1 lab def inscat 1 "Other" 2 "POS" 3 "HMO" lab val inscat inscat lab var inscat "Insurance, categorical" gen maxmmerd=round(maxmme, 10) fre maxmmerd, all lab var maxmmerd "Max daily MME rounded to nearest ten" gen odmme=maxmmerd recode odmme (min/89=0)(90/max=1) lab var odmme "MME>or equal to 90mg, high overdose potential" fre odmme gen divmme=maxmmerd recode divmme (min/499=0)(500/max=1) lab var divmme "Avg MME>or equal to 1000mg, diversion potential" fre divmme gen age10=age/10 lab var age10 "Age in tens of years" gen BPprpct10= BPprpct/10 gen WPprpct10=WPprpct/10 gen BPbiprpct10=BPbiprpct/10 gen WPbiprpct10=WPbiprpct/10 gen numdocstrunc=numdocs recode numdocstrunc (4/max=4) lab var numdocstrunc "Truncated version of numdocs bc one supplemental model will not converge with original" *Drop cases missing [no missing] egen miss=rowmiss(female age appseven cancer inscat numdocs pagerank numrx) drop if miss>0 *Descriptives xttab cancer xttab odmme xttab divmme xttab female xttab lowinc xttab appseven xttab inscat xttab oud xttab anyod xtsum age degree pagerank bidegree birank prpctile biprpctile numdocs numrx numpharm maxmme fre BPprpct WPprpct sum BPprpct WPprpct xttab odmme if prpctile>=90 xttab odmme if prpctile>=95 xttab odmme if prpctile>=99 xttab divmme if prpctile>=90 xttab divmme if prpctile>=95 xttab divmme if prpctile>=99 *Pairwise correlations pwcorr prpctile degree numrx numdocs numpharm avgmme, sig oneway prpctile inscat ttest prpctile, by(female) ttest prpctile, by(lowinc) ttest prpctile, by(divmme) ttest prpctile, by(odmme) ttest prpctile, by(anyod) ttest prpctile, by(oud) *Histograms histogram numrx histogram numpharm histogram numdocs histogram pagerank histogram birank histogram WPprpct histogram BPprpct histogram WPbiprpct histogram BPbiprpct histogram degree histogram bidegree *MULTIVARIATE MODELS *FINAL MODELS xtnbreg numrx female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven, irr margins, at(BPprpct10=(2 4 6 8 10)) margins, at(WPprpct10=(-6 -4 -2 0 2 4 6)) estat ic xtlogit odmme female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven, or margins, at(BPprpct10=(2 4 6 8 10)) margins, at(WPprpct10=(-6 -4 -2 0 2 4 6)) estat ic xtlogit oud female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven, or margins, at(BPprpct10=(2 4 6 8 10)) margins, at(WPprpct10=(-6 -4 -2 0 2 4 6)) estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven, or margins, at(BPprpct10=(2 4 6 8 10)) margins, at(WPprpct10=(-6 -4 -2 0 2 4 6)) estat ic *Sensitivity Analysis 1 - replicate after omitting patients with <= one prescriber per quarter *Switch to xtpoisson because no longer zero inflated bysort patid: egen meandocs=mean(numdocs) lab var meandocs "Mean number of unique doctors per quarter over all quarters" xtpoisson numrx female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven if meandocs>1, irr estat ic xtlogit odmme female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven if meandocs>1, or estat ic xtlogit oud female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven if meandocs>1, or estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.appseven if meandocs>1, or estat ic *Sensitivity Analysis 2 - replicate with bipartite PageRank xtnbreg numrx female age10 cancer i.inscat numdocs BPbiprpct10 WPbiprpct10 i.appseven, irr estat ic *xtlogit and xtmelogit do not converge - will only converge when numdocs is right-truncated xtlogit odmme female age10 cancer i.inscat numdocstrunc BPbiprpct10 WPbiprpct10 i.appseven, or estat ic xtlogit odmme female age10 cancer i.inscat logdocs BPbiprpct10 WPbiprpct10 i.appseven, or estat ic xtlogit oud female age10 cancer i.inscat numdocs BPbiprpct10 WPbiprpct10 i.appseven, or estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPbiprpct10 WPbiprpct10 i.appseven, or estat ic *Sensitivity analysis 3 - with standardized raw pagerank xtnbreg numrx female age10 cancer i.inscat numdocs BPstdpr WPstdpr i.appseven, irr estat ic xtlogit odmme female age10 cancer i.inscat numdocs BPstdpr WPstdpr i.appseven, or estat ic xtlogit oud female age10 cancer i.inscat numdocs BPstdpr WPstdpr i.appseven, or estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPstdpr WPstdpr i.appseven, or estat ic *Sensitivity analysis 4 - Replicate with logged degree centrality xtnbreg numrx female age10 cancer i.inscat numdocs BPlogdegree WPlogdegree i.appseven, irr estat ic xtlogit odmme female age10 cancer i.inscat numdocs BPlogdegree WPlogdegree i.appseven, or estat ic xtlogit oud female age10 cancer i.inscat numdocs BPlogdegree WPlogdegree i.appseven, or estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPlogdegree WPlogdegree i.appseven, or estat ic *Sensitivity Analysis 5 - replicate with city-level fixed effects - FOOTNOTE ONLY (no table) xtnbreg numrx female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.citygrp, irr estat ic xtlogit odmme female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.citygrp, or estat ic xtlogit oud female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.citygrp, or estat ic xtlogit anyod female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.citygrp, or estat ic *Reviewer comment regarding diversion potential xtlogit divmme female age10 cancer i.inscat numdocs BPprpct10 WPprpct10 i.citygrp, or estat ic log close