Costs of Adverse Drug Events in German Hospitals—A Microcosting Study

Abstract

This is one of the first administrative data-based analyses calculating the economic consequences of ADEs in Germany. Further efforts are necessary to improve pharmacotherapy and relieve health care payers of preventable treatment costs.

A systematic review of approaches for calculating the cost of medication errors

“…Only four studies14 17 21 27 used internal controls as part of the study design. Two studies9 28 included a sensitivity analysis within the calculation for costing MEs.…”

“…Both studies were conducted in different countries and therefore the meaning of labour costs, in the absence of further clarification, was unknown. Similarly, Al-lela et al 16 and Rottenkolber et al 27 used a microcosting method but applied the approach differently in both studies. Al-lela et al 16 added only medication costs to labour costs to derive a cumulative cost, whereas Rottenkolber et al 27 also included infrastructure, pharmaceutical and personnel costs as part of the calculation.…”

“…Lampert et al 23 used a single input cost for a single stage calculation to investigate the cost of MEs, whereas Rottenkolber et al 27 used multiple inputs (‘every resource consumed’) into a multistage calculation for costing MEs. Aceves-Avila et al 6 calculated MEs using two inputs, for example, cost of medication and cost of a day's income for the patient, whereas Field et al 8 generated multiple inputs by taking into account the wider costs within the clinical environment.…”

The direct costs of drug-induced skin reactions

“…The excess balance was €970 per patient in the group treated for drug-induced adverse effects. However, no data were provided regarding the cause for such a surplus [11].…”

CP-235 Cost–benefit analysis of clinical pharmacist interventions in geriatric wards

“…Purpose This study estimated the cost-benefit ratio of clinical pharmacist interventions for 5 months in three geriatric services in a secondary care hospital. Material and methods To estimate the benefit, we computed for each intervention the cost savings related to drugs and biologic tests added or deleted, and the cost avoidance related to preventable serious adverse drug events (ADEs) avoided by multiplying ADE occurrence probability (Nesbit et al, 2001) by its cost (Rottenkolber et al, 2012). For each intervention a pharmacist and a physician blindly assigned a probability that an ADE would have occurred in the absence of an intervention, according to the Nesbit Scale.…”