Gabriel Rodrigues Martins de Freitas1, Mariana Younes Tramontina2, Giacomo Balbinotto3, Dyfrig Arwyn Hughes4, Isabela Heineck2. 1. Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: grmf.pharma@gmail.com. 2. Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. 3. Faculty of Economics Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. 4. Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Wales, UK.
Abstract
OBJECTIVES: To estimate the cost of managing drug-related morbidity (DRM) that leads to visits to the emergency department of a Brazilian hospital. METHODS: This is a cost-of-illness study based on a retrospective cross-sectional analysis of patients' medical records. A questionnaire and analysis of medical records were used to identify patients who were being admitted to the emergency department because of DRM. The direct medical costs of patient management were estimated using a microcosting analysis, and a sensitivity analysis was conducted using the emergency department visit rates due to DRM reported in the literature. RESULTS: Of the total patients interviewed, 14.6% sought emergency care because of DRM and 58.9% were considered preventable. Mean treatment costs were US $900 ± $1,569 (range US $18-$10,847). An extrapolation based on all emergency visits in the last year resulted in annual total treatment costs of US $7.5 million (US $1.1-$1.4 million). It was observed that 39.3% of the total cost of DRM was attributed to adverse drug reactions, 36.9% to nonadherence to treatment, and 16.9% to incorrect dosages. CONCLUSIONS: Adverse drug reactions and nonadherence to treatment are important causes of morbidity and cost to the health service. Much of this resource is spent to treat preventable cases of DRM, which represents a great waste of resources.
OBJECTIVES: To estimate the cost of managing drug-related morbidity (DRM) that leads to visits to the emergency department of a Brazilian hospital. METHODS: This is a cost-of-illness study based on a retrospective cross-sectional analysis of patients' medical records. A questionnaire and analysis of medical records were used to identify patients who were being admitted to the emergency department because of DRM. The direct medical costs of patient management were estimated using a microcosting analysis, and a sensitivity analysis was conducted using the emergency department visit rates due to DRM reported in the literature. RESULTS: Of the total patients interviewed, 14.6% sought emergency care because of DRM and 58.9% were considered preventable. Mean treatment costs were US $900 ± $1,569 (range US $18-$10,847). An extrapolation based on all emergency visits in the last year resulted in annual total treatment costs of US $7.5 million (US $1.1-$1.4 million). It was observed that 39.3% of the total cost of DRM was attributed to adverse drug reactions, 36.9% to nonadherence to treatment, and 16.9% to incorrect dosages. CONCLUSIONS: Adverse drug reactions and nonadherence to treatment are important causes of morbidity and cost to the health service. Much of this resource is spent to treat preventable cases of DRM, which represents a great waste of resources.