Comparing Methods for Estimating Direct Costs of Adverse Drug Events

Abstract

The estimated costs resulting from ADEs varied considerably depending on the methodological choices. The results indicate that costs for ADEs need to be identified through medical record review and by using detailed unit cost data.

Healthcare costs of adverse drug reactions and potentially inappropriate prescribing in older adults: a population-based study

“… 10 The cost evaluation method employed was the resource use method. 29 The reviewers were instructed that the ADE contributing the most to costs should be listed first. If the first ADE listed by a reviewer was an ADR, any additional ADEs contributing to the resource use during that same healthcare encounter could potentially contribute to an overestimation of cost.…”

“… 29 Costs assessed as dominantly caused by an ADR can be expected to better represent the actual costs to the health system. 29 The analyses in this article are descriptive in nature, and the results were not adjusted for other factors, such as comorbidities. Thus, methods for estimating the attributable costs of ADRs were not used, such as adjusted regression analyses or propensity score matching, due to residual confounding limiting the comparability of groups.…”

“…Prevalence-based direct costs for healthcare and drug use during the 3-month study period were calculated, both as the total cost for all healthcare encounters and dispensed drugs, and as the cost caused by ADRs employing the resource use method. 29 The ADR costs were derived from a study evaluating costs of ADEs, in mutually exclusive categories including ADRs, and their contribution to healthcare encounters. 10 The reviewers were instructed that the ADE contributing most to costs should be listed first.…”

“…29 Thus, although the total cost reported is the cost used by the Region in their administrative system and should Open access be well representing the healthcare costs in this patient group, the reported cost resulting from specific ADRs is likely underestimated, and should be viewed as more of an indication of its distribution. 29 Costs assessed as dominantly caused by an ADR can be expected to better represent the actual costs to the health system. 29 The analyses in this article are descriptive in nature, and the results were not adjusted for other factors, such as comorbidities.…”

The Transporter-Mediated Cellular Uptake and Efflux of Pharmaceutical Drugs and Biotechnology Products: How and Why Phospholipid Bilayer Transport Is Negligible in Real Biomembranes

“…Notwithstanding all the benefits of small molecule drugs, it remains the case that they are also widely associated with various morbidities and mortalities, often referred to as “adverse drug reactions” (ADRs) (e.g., [ 326 , 327 , 328 , 329 , 330 , 331 , 332 , 333 , 334 , 335 , 336 , 337 , 338 , 339 , 340 , 341 , 342 , 343 , 344 , 345 , 346 ]). Despite the lengthy and complex regulatory hurdles that drugs must overcome before being marketed (and toxicity remains a major cause of so-called “attrition” where drug candidates are pulled before they even get to market [ 347 , 348 , 349 , 350 , 351 , 352 , 353 ]), ADRs are extremely common (and hard to anticipate, given the huge genetic and phenotypic variation in human populations [ 354 ]).…”