Laroche Marie-Laure, Tarbouriech Noémie, Jai Taha, Valnet-Rabier Marie-Blanche, Nerich Virginie
Regional Pharmacovigilance Centre of Limoges, Department of Pharmacology-Toxicology and Pharmacovigilance, CHU Limoges, Limoges, France.
UR 24134 (VieSanté-Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France.
Br J Clin Pharmacol. 2025 Feb;91(2):439-450. doi: 10.1111/bcp.16266. Epub 2024 Oct 3.
Hospitalizations for adverse drug reactions (ADR-HA) have increased over the last decade, but the impact of ADR-HA has rarely been evaluated. The aim of this study was to estimate the economic burden of ADR-HA in France.
A partial economic evaluation from the viewpoint of French public health insurance was performed, based on a previous pharmacovigilance study (IATROSTAT) performed in 2018 in public hospital medical units. The cost included direct medical costs, collected retrospectively, from the French hospital discharge database. The economic burden was estimated by calculating the total cost per ADR-HA patient (cost of hospital stays, additional daily cost of specific stays, such as in a resuscitation, intensive care or continuous surveillance unit, drug products and medical devices in addition to Healthcare Resource Group-based tariffs, and specific outpatient consultations and other clinical and technical medical procedures, over 3 months as from the first day of ADR-HA). The robustness of the results was assessed using a one-way deterministic sensitivity analysis of cost factors applying tariffs from 2023 instead of 2018.
According to the 2018 tariffs (vs. 2023), the mean total cost per patient with ADR-HA was estimated at €5208 ± €3719 (vs. €5974 ± €4232) ranging from €514 to €23 355 (vs. €618 to €27 380). The total cost for 196 patients with ADR-HA admitted to a sample of French public hospitals was estimated at €1 020 549 (vs. €1 170 960). It could be estimated at €1.3 billion at the national level.
In addition to the increase in the number of expensive drugs, the ageing population and polypharmacy, the economic impact of serious ADR-HA weighs heavily on healthcare spending.
在过去十年中,因药物不良反应导致的住院治疗(ADR-HA)有所增加,但ADR-HA的影响很少得到评估。本研究的目的是估计法国ADR-HA的经济负担。
基于2018年在公立医院医疗单位进行的一项先前的药物警戒研究(IATROSTAT),从法国公共医疗保险的角度进行了部分经济评估。成本包括从法国医院出院数据库中回顾性收集的直接医疗成本。通过计算每位ADR-HA患者的总成本(住院费用、特定住院的额外每日费用,如在复苏、重症监护或持续监测病房的费用、除基于医疗资源组的收费标准外的药品和医疗器械费用,以及特定的门诊咨询和其他临床及技术医疗程序费用,从ADR-HA第一天起的3个月内)来估计经济负担。使用单向确定性敏感性分析,应用2023年而非2018年的收费标准对成本因素进行评估,以评估结果的稳健性。
根据2018年的收费标准(与2023年相比),每位ADR-HA患者的平均总成本估计为5208欧元±3719欧元(与5974欧元±4232欧元相比),范围为514欧元至23355欧元(与618欧元至27380欧元相比)。法国公立医院样本中196例ADR-HA患者的总成本估计为1020549欧元(与1170960欧元相比)。在国家层面估计可能为13亿欧元。
除了昂贵药物数量增加、人口老龄化和多重用药外,严重ADR-HA的经济影响对医疗支出造成了沉重负担。