PMID- 21384463
OWN - NLM
STAT- MEDLINE
DCOM- 20111013
LR  - 20131121
IS  - 1099-1557 (Electronic)
IS  - 1053-8569 (Linking)
VI  - 20
IP  - 6
DP  - 2011 Jun
TI  - Adverse drug reactions in Germany: direct costs of internal medicine 
      hospitalizations.
PG  - 626-34
LID - 10.1002/pds.2118 [doi]
AB  - PURPOSE: German hospital reimbursement modalities changed as a result of the 
      introduction of Diagnosis Related Groups (DRG) in 2004. Therefore, no data on the 
      direct costs of adverse drug reactions (ADRs) resulting in admissions to 
      departments of internal medicine are available. The objective was to quantify the 
      ADR-related economic burden (direct costs) of hospitalizations in internal 
      medicine wards in Germany. METHODS: Record-based study analyzing the patient 
      records of about 57,000 hospitalizations between 2006 and 2007 of the Net of 
      Regional Pharmacovigilance Centers (Germany). All ADRs were evaluated by a team 
      of experts in pharmacovigilance for severity, causality, and preventability. The 
      calculation of accurate person-related costs for ADRs relied on the German DRG 
      system (G-DRG 2009). Descriptive and bootstrap statistical methods were applied 
      for data analysis. RESULTS: The incidence of hospitalization due to at least 
      'possible' serious outpatient ADRs was estimated to be approximately 3.25%. Mean 
      age of the 1834 patients was 71.0 years (SD 14.7). Most frequent ADRs were 
      gastrointestinal hemorrhage (n = 336) and drug-induced hypoglycemia (n = 270). 
      Average inpatient length-of-stay was 9.3 days (SD 7.1). Average treatment costs 
      of a single ADR were estimated to be approximately euro2250. The total costs sum to 
      euro434 million per year for Germany. Considering the proportion of preventable 
      cases (20.1%), this equals a saving potential of euro87 million per year. 
      CONCLUSIONS: Preventing ADRs is advisable in order to realize significant 
      nationwide savings potential. Our cost estimates provide a reliable benchmark as 
      they were calculated based on an intensified ADR surveillance and an accurate 
      person-related cost application.
CI  - Copyright (c) 2011 John Wiley & Sons, Ltd.
FAU - Rottenkolber, Dominik
AU  - Rottenkolber D
AD  - Ludwig-Maximilians-Universitat Munchen, Institute of Health Economics and Health 
      Care Management and Munich Center of Health Sciences, Munich, Germany. 
      rottenkolber@bwl.lmu.de
FAU - Schmiedl, Sven
AU  - Schmiedl S
FAU - Rottenkolber, Marietta
AU  - Rottenkolber M
FAU - Farker, Katrin
AU  - Farker K
FAU - Salje, Karen
AU  - Salje K
FAU - Mueller, Silke
AU  - Mueller S
FAU - Hippius, Marion
AU  - Hippius M
FAU - Thuermann, Petra A
AU  - Thuermann PA
FAU - Hasford, Joerg
AU  - Hasford J
CN  - Net of Regional Pharmacovigilance Centers
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110308
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Adverse Drug Reaction Reporting Systems/*statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Costs and Cost Analysis
MH  - Data Interpretation, Statistical
MH  - Drug-Related Side Effects and Adverse Reactions/*economics
MH  - Female
MH  - Germany
MH  - Hospital Departments/economics
MH  - Hospitalization/*economics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Young Adult
EDAT- 2011/03/09 06:00
MHDA- 2011/10/14 06:00
CRDT- 2011/03/09 06:00
PHST- 2010/06/25 00:00 [received]
PHST- 2010/10/13 00:00 [revised]
PHST- 2011/01/13 00:00 [accepted]
PHST- 2011/03/09 06:00 [entrez]
PHST- 2011/03/09 06:00 [pubmed]
PHST- 2011/10/14 06:00 [medline]
AID - 10.1002/pds.2118 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2011 Jun;20(6):626-34. doi: 10.1002/pds.2118. Epub 
      2011 Mar 8.