Abstract
BackgroundThe aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population.MethodsWe conducted a population-based observational retrospective cohort study of ADEs identified from medical records. From a random sample of 5025 adults in a Swedish county council, 4970 were included in the analyses. During a three-month study period in 2008, direct and indirect costs were estimated from resource use identified in the medical records and from register data on costs for resource use.ResultsAmong 596 patients with ADEs, the average direct costs per patient caused by ADEs were USD 444.9 [95% CI: 264.4 to 625.3], corresponding to USD 21 million per 100 000 adult inhabitants per year. Inpatient care accounted for 53.9% of all direct costs caused by ADEs. For patients with ADEs, the average societal cost of illness was USD 6235.0 [5442.8 to 7027.2], of which direct costs were USD 2830.1 [2260.7 to 3399.4] (45%), and indirect costs USD 3404.9 [2899.3 to 3910.4] (55%). The societal cost of illness was higher for patients with ADEs compared to other patients. ADEs caused 9.5% of all direct healthcare costs in the study population.ConclusionsHealthcare costs for patients with ADEs are substantial across different settings; in primary care, other outpatient care and inpatient care. Hence the economic impact of ADEs will be underestimated in studies focusing on inpatient ADEs alone. Moreover, the high proportion of indirect costs in the societal COI for patients with ADEs suggests that the observed costs caused by ADEs would be even higher if including indirect costs. Additional studies are needed to identify interventions to prevent and manage ADEs.
Highlights
Adverse drug events (ADEs), ’’injuries resulting from medical intervention related to a drug’’,[1] cause significant harm to patients and increased resource use
The aim of this study was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal cost of illness (COI), for patients with ADEs and for the entire study population
Among the 596 patients with at least one ADE, the average direct costs per patient caused by ADEs were United States dollar (USD) 444.9 [264.4 to 625.3], including the full cost of the 991 healthcare encounters dominantly caused by ADEs and the costs of interventions for diagnosing, treating or monitoring ADEs in the 1025 additional encounters
Summary
Adverse drug events (ADEs), ’’injuries resulting from medical intervention related to a drug’’,[1] cause significant harm to patients and increased resource use. It has been estimated that 5– 6% of all hospitalisations are drug-related,[2,3] and the additional hospitalisation costs of patients experiencing ADEs have been estimated to USD 2284–5640 per patient (2000 values).[4] indirect costs, costs in the general population, and costs in outpatient settings, caused by ADEs, have not been included. The aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population
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