Abstract
The aim of this study was to assess costs and health service use associated with tendon injuries after the use of fluoroquinolone antimicrobials in Finland during 2002–2012. This retrospective observational study included data from the Finnish Pharmaceutical Insurance Pool's pharmaceutical injury claims. In total, 145 compensated claimants aged ≥18 years presenting tendon injuries after the use of fluoroquinolones (FQs) were included in the study. Outcomes of interest were the number of outpatient visits to primary, secondary, tertiary, and private healthcare services, hospital days, rehabilitation and their costs. Regression models were used to analyze the impact of patient characteristics on hospital days, as well as the relationship between patient characteristics and tendon ruptures. Direct costs of a tendon injury averaged 14,800€ and indirect costs were estimated to be 9,077€ for employed claimants. Fifty‐one percent of the claimants were hospitalized, with an average duration of 21 days. Hospitalization was the costliest form of health service use with an average of 9,915€ per hospital episode. Hospital days and direct costs increased with the severity of the injury. Tendon ruptures, in particular bilateral ruptures, required substantially more hospital days and their direct costs were significantly higher than those of uncomplicated tendinitis. Concurrent use of oral corticosteroids and increasing age were associated with a higher likelihood of tendon ruptures. Although rare, FQ‐related tendon injuries can result in considerable costs and health service use. Medical staff should remain vigilant when prescribing FQs, especially in groups at increased risk for tendon injuries.
Highlights
FQs are generally well tolerated, they have been associated with serious adverse events (AEs), such as tendon injuries, aortic wall injuries, Abbreviations: AEs, adverse events; EMA, European Medicines Agency; FDA, Food and Drugs Administration; FQs, Fluoroquinolones
Our study found that the 145 claimants with tendon injuries had an average of 14,800€ direct costs in addition to the indirect costs that were estimated to be 9077€ for employed claimants
Hospitalization was the costliest form of health service use amounting to an average of 9915€ per hospital episode
Summary
Tendon injuries are treated with immobilization and/or corrective surgery.[7] Both tendinitis and tendon ruptures can either heal completely or cause permanent damage to the tendon. The treatment of these serious AEs often requires both sick leave and health service use, which, in turn, cause potentially significant costs for patients and society. Previous research has shown that assessments of FQ-related AE costs are scarce even though hospitalization is frequently required to treat AEs.[8]
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