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

Abstract Objective In Germany, only limited data are available to quantify the attributable resource utilization associated with adverse drug events (ADEs). The aim of this study was twofold: first, to calculate the direct treatment costs associated with ADEs leading to hospitalization and, second,...

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Bibliographic Details
Published in:Value in health 2012-09, Vol.15 (6), p.868-875
Main Authors: Rottenkolber, Dominik, MBR, Hasford, Joerg, MD, Stausberg, Jürgen, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
adverse drug events
Aged
Aged, 80 and over
Child
Child, Preschool
cost accounting
Costs and Cost Analysis
Diagnosis-Related Groups
Drug-Related Side Effects and Adverse Reactions - economics
Extrapolation
Female
Germany
Health costs
Hospitalization
Hospitals
Hospitals, Public - economics
Humans
Infant
Internal Medicine
Male
Medical Audit
Middle Aged
Retrospective Studies
Suffering
Young Adult
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Summary:Abstract Objective In Germany, only limited data are available to quantify the attributable resource utilization associated with adverse drug events (ADEs). The aim of this study was twofold: first, to calculate the direct treatment costs associated with ADEs leading to hospitalization and, second, to derive the excess costs and extra hospital days attributable to ADEs of inpatient treatments in selected German hospitals. Methods This was a retrospective and medical record–based study performed from the hospitals' perspective based on administrative accounting data from three hospitals (49,462 patients) in Germany. Total treatment costs (“analysis 1”) and excess costs (i.e., incremental resource utilization) between patients suffering from an ADE and those without ADEs were calculated by means of a propensity score–based matching algorithm (“analysis 2”). Results Mean treatment costs (“analysis 1”) of ADEs leading to hospitalization (n = 564) were €1,978 ± 2,036 (range €191–18,147; median €1,446; €843–2,480 [Q1–Q3]). In analysis 2, the mean costs of inpatients suffering from an ADE (n = 1,891) as a concomitant disease or complication (€5,113 ± 10,059; range €179–246,288; median €2,701; €1,636–5,111 [Q1–Q3]) were significantly higher (€970; P < 0.0001) than those of non-ADE inpatients (€4,143 ± 6,968; range €154–148,479; median €2,387; €1,432–4,701 [Q1–Q3]). Mean inpatient length of stay of ADE patients (12.7 ± 17.2 days) and non-ADE patients (9.8 ± 11.6 days) differed by 2.9 days ( P < 0.0001). A nationwide extrapolation resulted in annual total treatment costs of €1.058 billion. Conclusions 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.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2012.05.007