Cost Evaluation of Adverse Drug Reactions in Hospitalized Patients in Taiwan: A Prospective, Descriptive, Observational Study

摘要

BACKGROUND: Adverse drug reactions (ADRs) are a leading cause of morbidity and mortality. In the United States, ADR-related morbidity and mortality costs have been estimated at US dollar30 billion to US dollar130 billion annually. Objectives: The aim of this study was to evaluate the incidence of ADRs in Taiwan, to identify the drug classes that are most commonly related to ADRs, and to determine the direct medical costs to hospitals associated with prolonged hospitaliza-tions due to ADRs. METHODS: In this prospective, descriptive, observational study, patients who experienced ADRs during their hospitalization at a Taiwan teaching hospital or who were admitted due to an ADR from January 1, 2002, through December 31, 2004, were included in the study. The patients were identified actively by clinical pharmacists and passively by physicians and nurses who reported ADRs. The World Health Organization (WHO) definition of ADR severity was adopted, and degrees of probability for each ADR were determined usingthe Naranjo algorithm. The direct medical costs incurred to the hospital in the treatment of ADRs that prolonged hospitaliza-tion were calculated (ie, costs of emergency department {ED} visits, intensive care unit visits, extra days of hospkalization, monitoring and laboratory, studies, pharmacist dispensing fees, physician fees, room charges, ED charges).