AHRQ Analysis Estimates Costs of Adverse Drug Events in Hospitals

A new article by AHRQ researchers estimates that adverse drug events (ADEs) associated with anticoagulants and hypoglycemic agents each added about $2.5 billion to annual hospital costs in 2013. Adverse events are common among hospital patients who are treated with anticoagulants to encourage blood clotting or hypoglycemic agents to manage blood sugar levels. Researchers used nationally representative hospital data from the agency’s Healthcare Cost and Utilization Project and the Medicare Patient Safety Monitoring System to identify adverse events and calculate associated additional hospital costs. They estimated that in 2013 there were 250,000 ADEs from anticoagulants and 600,000 ADEs from hypoglycemic agents. Anticoagulant ADEs added more to the cost of hospital stays than hypoglycemic ADEs ($10,250 versus $4,300). Access the abstract of the article, which was published in the journal Medical Care.

2017 Jul 24. doi: 10.1097/MLR.0000000000000780. [Epub ahead of print]

The Marginal Costs of Adverse Drug Events Associated With Exposures to Anticoagulants and Hypoglycemic Agents During Hospitalization.

Spector WD1, Limcangco R, Furukawa MF, Encinosa WE.

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Abstract

BACKGROUND:

Anticoagulants and hypoglycemic agents are 2 of the most challenging drug classes for medical management in the hospital resulting in many adverse drug events (ADE).

OBJECTIVE:

Estimating the marginal cost (MC) of ADEs associated with anticoagulants and hypoglycemic agents for adults in 5 patient groups during their hospital stay and the total annual ADE costs for all patients exposed to these drugs during their stay.

RESEARCH DESIGN AND SUBJECT:

Data are from 2010 to 2013 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and Medicare Patient Safety Monitoring System (MPSMS). Deidentified patients were linked using probabilistic matching in the same hospital and year for 5 patient groups. ADE information was obtained from the MPSMS using retrospective structured record review. Costs were derived using HCUP cost-to-charge ratios. MC estimates were made using Extended Estimating Equations controlling for patient characteristics, comorbidities, hospital procedures, and hospital characteristics. MC estimates were applied to the 2013 HCUP National Inpatient Sample to estimate annual ADE costs.

RESULTS:

Adjusted MC estimates were smaller than unadjusted measures with most groups showing estimates that were at least 50% less. Adjusted anticoagulant ADE costs added >45% and Hypoglycemic ADE costs added >20% to inpatient costs. The 2013 hospital cost estimates for ADEs associated with anticoagulants and hypoglycemic agents were >$2.5 billion for each drug class.

CONCLUSIONS:

This study demonstrates the importance of accounting for confounders in the estimation of ADEs, and the importance of separate estimates of ADE costs by drug class.