Drug-Induced Blood Consumption: The Impact of Adverse Drug Reactions on Demand for Blood Components in German Departments of Internal Medicine

Authors

  • Dominik Rottenkolber,

    Corresponding author
    1. Helmholtz Zentrum München–German Research Center for Environmental Health (GmbH), Neuherberg, Germany
    • Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management and Munich Center of Health Sciences, Munich, Germany
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  • Sven Schmiedl,

    1. Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Wuppertal, Germany
    2. Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
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  • Marietta Rottenkolber,

    1. IBE–Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
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  • Petra A. Thuermann,

    1. Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Wuppertal, Germany
    2. Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
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  • Joerg Hasford,

    1. IBE–Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
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  • the Net of Regional Pharmacovigilance Centers


Author for correspondence: Dominik Rottenkolber, Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management, Ludwigstr. 28 RG V, 80539 Munich, Germany (fax + 49 0 89 2180 1475, e-mail rottenkolber@bwl.lmu.de).

Abstract

Therapy for adverse drug reactions (ADRs) often results in the application of blood components. This study aims to assess the demand for blood components and the resulting economic burden (hospital perspective) in German hospitals induced by ADRs leading to admissions to departments of internal medicine. In this prospective study, ADRs leading to hospitalization were surveyed in four regional pharmacovigilance centres in Germany during the years 2000–2007. ADRs assessed as ‘possible’, ‘likely’ or ‘very likely’ were included. Market prices for blood components and hospitalization data were determined by desktop research. A probabilistic sensitivity analysis was performed. A total of 6099 patients were admitted to internal medicine departments because of an outpatient ADR of whom 1165 patients (19.1%; mean age, 73.0 ± 13.0 years) required treatment with blood components owing to major bleeding events. Overall consumption was 4185 erythrocyte concentrates (EC), 426 fresh frozen plasma (FFP) and 48 thrombocyte (TC) units. On the basis of statistical hospital data, we estimated a nationwide demand of approximately 132,020 EC, 13,440 FFP and 1515 TC units, resulting in total costs of €12.66 million per year for all German hospitals. Some 19.2% of all ADR cases were assessed as preventable. Theoretically, a nationwide decreased demand for blood components and a savings potential of €2.43 million per year could be achieved by preventing ADRs in Germany. Blood components are used in one-fifth (mainly gastrointestinal bleeding) of all ADRs, leading to hospitalizations in internal medicine departments. Both blood demand and hospital procurement costs can be significantly lowered by preventing ADRs.

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