Adverse Drug Reactions Cost $1.5 Billion a Year, Study Finds

Documenting that medication is often a double-edged sword, Utah researchers report today that drugs cause painful side effects or disabilities in more than 770,000 Americans annually, costing hospitals at least $1.5 billion.

Those figures are based on the largest analysis yet of “adverse drug events.” Of 91,000 patients admitted to LDS Hospital in Salt Lake City over four years, 2,227, or 2.4%, experienced a negative reaction to medication, including itching, nausea, dangerously low blood pressure, dizziness and kidney failure. Such reactions added nearly two days and $2,000 to patients’ hospital stays. The researchers also documented several deaths due to drug reactions.

The Utah study is one of three in today’s Journal of the American Medical Assn. that analyzes adverse drug reactions in hospital patients. Boston researchers found the problem to be about as common and costly as did the Utah researchers. Pharmacists at Albany Medical College in New York discovered that four of 1,000 prescriptions for hospitalized patients contained an error, including prescribing drugs that patients were allergic to or giving them the wrong dosage.

Taken together, the studies are a “clarion call” to patients and health care providers to make drug therapy safer, said Dr. John Burke, an epidemiologist at LDS Hospital and lead author of the Utah study.

In addition to costing hospitals millions of dollars annually, adverse drug reactions can lead to disabilities requiring long-term treatment and are a leading reason for medical malpractice suits.

Previous studies have estimated that coping with adverse prescription drug reactions costs society about $47 billion each year, making the problem as expensive as some major diseases. For instance, diabetes care costs $45 billion annually.

To reduce the chances of becoming a victim of “drug misadventures,” as researchers put it, Burke recommended keeping track of drug allergies and making them known to doctors, perhaps by wearing an identification bracelet; always telling doctors of any other drugs being consumed, in case of negative interactions; and, if possible, alerting doctors to changes in kidney and other organ functions during an illness, which could require adjusting drug dosages.

The researchers also called upon health care providers to develop computer systems to better monitor patients’ drug needs and warn of prescribing errors. Reducing adverse drug events should ultimately save hospitals money as well as spare patients misery, the researchers say.

In the Utah study, patients who experienced an adverse drug reaction were taking an average of 12 different medications, which the researchers acknowledge increases the risk of negative reactions. The most common error doctors made was overdosing, and the drugs--ranging from painkillers to antibiotics to anti-cancer medications--most frequently involved in adverse events were morphine, digoxin, meperidine, oxycodon, acetaminophen, imipenem, cefazoin, warfarin and vancomycin.

The Albany researchers also found that the most common mistake was overdosing because of failure to consider patients’ diminished kidney function (13.9% of errors). Other doctor errors were prescribing allergy-causing medications (12.1%), using an incorrect name or abbreviation for a drug (11.4%), and making a math mistake in calculating the dosage (11.1%).