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Direct and indirect costs for adverse drug events identified in medical records across care levels, and their distribution among payers
Nordic School Public Health NHV, Sweden.
Nordic School Public Health NHV, Sweden; EPID Research, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Jonköping County Council, Sweden.
University of Gothenburg, Sweden.
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2017 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 13, no 6, p. 1151-1158Article in journal (Refereed) Published
Abstract [en]

Background: Adverse drug events (ADEs) cause considerable costs in hospitals. However, little is known about costs caused by ADEs outside hospitals, effects on productivity, and how the costs are distributed among payers. Objective: To describe the direct and indirect costs caused by ADEs, and their distribution among payers. Furthermore, to describe the distribution of patient out-of-pocket costs and lost productivity caused by ADEs according to socio-economic characteristics. Method: In a random sample of 5025 adults in a Swedish county, prevalence-based costs for ADEs were calculated. Two different methods were used: 1) based on resource use judged to be caused by ADEs, and 2) as costs attributable to ADEs by comparing costs among individuals with ADEs to costs among matched controls. Payers of costs caused by ADEs were identified in medical records among those with ADEs (n = 596), and costs caused to individual patients were described by socio-economic characteristics. Results: Costs for resource use caused by ADEs were (sic)505 per patient with ADEs (95% confidence interval (sic)345-665), of which 38% were indirect costs. Compared to matched controls, the costs attributable to ADEs were (sic)1631, of which (sic)410 were indirect costs. The local health authorities paid 58% of the costs caused by ADEs. Women had higher productivity loss than men ((sic)426 vs. (sic)109, p = 0.018). Out-of-pocket costs displaced a larger proportion of the disposable income among low-income earners than higher income earners (0.7% vs. 0.2%-0.3%). Conclusion: We used two methods to identify costs for ADEs, both identifying indirect costs as an important component of the overall costs for ADEs. Although the largest payers of costs caused by ADEs were the local health authorities responsible for direct costs, employers and patients costs for lost productivity contributed substantially. Our results indicate inequalities in costs caused by ADEs, by sex and income. (C) 2016 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2017. Vol. 13, no 6, p. 1151-1158
Keyword [en]
Adverse drug event; Cost of illness; Drug therapy; Medical records; Pharmacoepidemiology; Propensity score matching
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-143734DOI: 10.1016/j.sapharm.2016.11.008ISI: 000416976600011PubMedID: 27894838OAI: oai:DiVA.org:liu-143734DiVA: diva2:1166714
Note

Funding Agencies|National Corporation of Swedish Pharmacies (Apoteket AB); Region Vastra Gotaland; Ostergotland County Council

Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2017-12-15

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Hägg, Staffan
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Division of Drug ResearchFaculty of Medicine and Health SciencesDepartment of Clinical Pharmacology
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CiteExportLink to record
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