Evaluation of cost of treatment of drug-related events in a tertiary care public sector hospital in Northern India: a prospective study

Br J Clin Pharmacol. 2009 Mar;67(3):363-9. doi: 10.1111/j.1365-2125.2008.03346.x. Epub 2008 Dec 1.


Aims: Drug related events (DREs) contribute significantly to hospital admissions. These are largely preventable events and require optimum use of the therapeutic agents. The study was conducted to analyze the cost of treatment of DREs.

Patients & methods: All visits to medical emergency department of a tertiary care public sector hospital in northern India were recorded in a prospective, non-interventional manner over a period of 4 months. DREs were recognized and were followed up till their stay in the hospital. Data about the cost generating components of direct and indirect costs of treatment of DREs were collected. The projected cost of treatment of the same DREs in a private sector hospital was estimated and compared.

Results: Out of 1833 admissions, 92(5.01%) were due to DREs. Maximum cases were due to non compliance (66%) followed by ADR (28%) and drug overdose (6%). The common DREs leading to ED visits were cerebrovascular accident (19.44%), followed by accelerated hypertension (18.36%) and diabetic ketoacidosis(14.04%). Total cost of management of all the 92 DREs in our hospital was calculated to be INR17,37,339(Euro 30,215). The direct cost was INR1,72,961 (Euro 3008) and the approximate indirect cost was INR15,64,378 (Euro 27,206). The projected cost of management of all the 92 DREs was estimated to be INR63,63,872(Euro 1,01, 676) in a private sector hospital.

Conclusion: The study shows that ADEs leading to emergency department visits and hospitalizations constitute a significant economic burden. Training of the patients and the prescribers may lessen the economic burden on the patient as well as the health care system.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Interactions*
  • Drug Overdose / economics*
  • Drug Overdose / therapy
  • Emergency Medical Services / economics*
  • Female
  • Health Care Costs*
  • Hospitalization / economics*
  • Humans
  • India
  • Male
  • Middle Aged
  • Patient Compliance*
  • Program Evaluation
  • Prospective Studies
  • Young Adult