[Detection of drug risks after approval : Methods development for the use of routine statutory health insurance data]

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Sep;61(9):1075-1081. doi: 10.1007/s00103-018-2786-z.
[Article in German]


Adverse drug reactions are among the leading causes of death. Pharmacovigilance aims to monitor drugs after they have been released to the market in order to detect potential risks. Data sources commonly used to this end are spontaneous reports sent in by doctors or pharmaceutical companies. Reports alone are rather limited when it comes to detecting potential health risks. Routine statutory health insurance data, however, are a richer source since they not only provide a detailed picture of the patients' wellbeing over time, but also contain information on concomitant medication and comorbidities.To take advantage of their potential and to increase drug safety, we will further develop statistical methods that have shown their merit in other fields as a source of inspiration. A plethora of methods have been proposed over the years for spontaneous reporting data: a comprehensive comparison of these methods and their potential use for longitudinal data should be explored. In addition, we show how methods from machine learning could aid in identifying rare risks. We discuss these so-called enrichment analyses and how utilizing pharmaceutical similarities between drugs and similarities between comorbidities could help to construct risk profiles of the patients prone to experience an adverse drug event.Summarizing these methods will further push drug safety research based on healthcare claim data from German health insurances which form, due to their size, longitudinal coverage, and timeliness, an excellent basis for investigating adverse effects of drugs.

Keywords: Adverse drug reaction reporting systems; Drug-related side effects and adverse reactions; Health claim data; Patient safety; Signal detection.

MeSH terms

  • Adverse Drug Reaction Reporting Systems*
  • Drug-Related Side Effects and Adverse Reactions*
  • Germany
  • Humans
  • Insurance, Health* / statistics & numerical data
  • Pharmacovigilance*