Calculating the cost for drug treatment including the adverse drug reactions treatment cost (primer for fentanyl TTS in Bulgaria).

This study presents the estimation and comparison of the direct outpatient costs associated with the use of Morphine slow-tard tabul and trans-dermal therapeutic system /TTS/ with Fentanyl for the treatment of the chronic pain in oncological patients. There are compared all outpatients' costs for the medicines under consideration--Morphine slow-tard tabul in two different packages and Fentanyl TTS. The calculation summarizes the price of the drug therapy for 15 days course, costs for care (physician, pharmaceutical, nursing), transport, storage. After the assessment of the costs for prophylactics and treatment of the adverse drug reactions /ADR/ associated with the use of the compared drugs by creating the "Decision tree" the respective cots are added to the direct cost of patients treatment. The direct treatment costs with Fentanyl TTS exceeded those with Morphine slow-tard with 10% and thus reflects the total costs for outpatient practice. The costs of treatment of the ADRs are higher with 69% for Morphine slow-tard due to high probability of appearance of the ADRs, their seriousness and duration.