Cost of Adverse Drug Reactions in a South Indian Tertiary Care Teaching Hospital

Abstract

In India, very few reports on the cost of adverse drug reactions (ADRs) are available. There is a need to study this aspect of health care in order to understand the economic burden imposed by ADRs. The aim of the current work was to study the costs associated with documented ADRs in a tertiary care teaching hospital. This study was conducted in medical wards of a south Indian tertiary care teaching hospital over a 6-month period. The study protocol was assessed and approved by the institutional ethics committee. A total of 317 ADRs from 246 patients were identified during the study period. The present study used an intensive monitoring method to detect ADRs and assessed an incidence of 32.7% adverse reactions in the monitored group. The causality, severity, predictability, and preventability of the documented ADRs were assessed. The total cost to the hospital due to ADRs was found to be Rs. 1,567,397 (US$36 451). The average cost per patient hospitalized with an ADR was Rs. 4,945 (US$115). The cost per reaction was found to be higher in the Indian context, as the per capita annual expenditure on health in this country is around US$109.

Adverse drug reactions in a tertiary care teaching hospital in India: analysis of spontaneously reported cases

“…18 The most common serious reaction was extrapyramidal symptoms in this study that is in contrast with the previous studies showing pancytopenia 15 and StevensJohnson syndrome (SJS). 21 In line with the previous study, most reactions had subacute and latent onset.…”

“…15,16,20 However, Jose and Rao observed similar incidence of 0.15% for both genders. 19 The adults showed high frequency of reactions, which is in concurrent with the studies by Venkatesan et al, 17 Rajkannan et al 18 and Rao et al 20 but differed from Ramesh et al 15 and Arulmani et al 16 showing high incidence in elderly.…”

“…16,19,21 The other most commonly reported system in the literature is a gastrointestinal tract. 15,17,18,20 In our study, gastrointestinal tract was second most commonly involved system. In one Indian study, gastrointestinal reactions occurred most commonly during hospitalization while cutaneous reactions most commonly accounted for hospitalization.…”

Knowledge, attitude and practice of pharmacovigilance among community pharmacists in Delhi, India

“…[1][2][3][4] Amongst the total ADRs, 0.2% to 41.3% lead to emergency hospitalizations worldwide and 28.9% of these ADRs are avertable. 5 Several studies have reported that misuse and irrational prescribing of drugs account for majority of ADRs.…”

“…5 Several studies have reported that misuse and irrational prescribing of drugs account for majority of ADRs. [1][2][3][4] India is one of the largest drug consuming countries in the world with substantial irrational prescribing and therefore increased likelihood of development of ADRs. 6 Thus, early identification and reporting of ADRs is extremely important from health and economical point of view.…”