Research has shown that patients are more likely to adhere to prescription regimens when they are prescribed more affordable generic products. However, state-level drug product selection laws and regulations control whether pharmacists can substitute brand-name drugs with generic versions of the same products. Drug product selection laws vary across states in whether they are automatic or permissive, whether they require patient consent, and whether there are exceptions (carve-outs) for certain drug classes.

This project aims to assess the impacts of state and federal laws on the practice of electronic syndromic surveillance (SyS) to monitor disease trends in near “real time.” The project will examine SyS systems operated by state and local health departments and their willingness to share SyS data with the Centers for Disease Control and Prevention (CDC) via the national BioSense system—a CDC-funded Internet “cloud-based” service hosted by the Association of State and Territorial Health Officials.

Many states have responded to the abuse of prescription opioids by developing a set of policies limiting access (e.g., prescription drug monitoring programs). While abuse is a continual concern, opioids play an important role in legitimate pain management: About one-third of the U.S. population struggles with chronic pain.

US welfare policy is governed by a labyrinthine set of laws that oversee program eligibility, enrollment procedures and the cash value of benefits received, some established at the federal level, and some delegated to the states. The delegation of the administration of US welfare programs to the states has created wide variations in overall program distributions, which ultimately has a substantial impact on state poverty levels, income inequality and the direct program benefits that people receive.