We explain a surprising effect of tort liability in the market for prescription drugs. Greater punitive damage risk seems to increase prescription drug utilization in states without non-economic damage caps but decrease utilization in states with such caps. We offer an explanation for this puzzle. The vertical production process for drugs involves national upstream producers (drug companies) and local downstream producers (doctors). When a single state reallocates liability from downstream to upstream producers, national drug companies see little reason to alter their nationwide output decisions, but local physicians have incentives to increase their prescriptions in that state. The net result is higher local output. We show how this dynamic can explain our puzzle by demonstrating that punitive damages shift liability upstream from doctors to drug companies, but not when non-economic damages caps limit physician malpractice liability. We provide evidence explaining when, how, and why this type of liability shifting occurs (JEL K13, I11, I18).

中文翻译：

---

产品责任的意外后果：来自药品市场的证据

我们解释了处方药市场中侵权责任的惊人影响。在没有非经济损失上限的州，更大的惩罚性损害风险似乎会增加处方药的利用率，但在有此类上限的州，处方药的利用率会下降。我们为这个难题提供一个解释。药品的垂直生产过程涉及国家上游生产商（药品公司）和地方下游生产商（医生）。当一个州将责任从下游生产者重新分配给上游生产商时，国家制药公司几乎没有理由改变其在全国范围内的产量决定，但是当地医生有动力增加该州的处方。最终结果是更高的本地输出。我们通过证明惩罚性赔偿将赔偿责任从上游转移到医生到制药公司来展示这种动力如何解释我们的难题，但是当非经济赔偿上限限制了医生的医疗事故赔偿责任时，则不能证明这一点。我们提供证据说明何时，如何以及为什么发生这种责任转移（JEL K13，I11，I18）。