The burden cost of adverse drug reaction related to admission at Chaophrayayommarat hospital
Main Article Content
Keywords
adverse drug reactions, health expenditure
Abstract
Background: Adverse Drug Reaction-related Hospital Admissions (ADRA) represent a significant impact on clinical problem and healthcare expenditure. This study aimed to determine the clinical manifestations, prevalence and cost burden from ADRA in the context of Chaophrayayommarat hospital, regional hospital level, Thailand. Methods: An observational study of adult patients who unplanned hospital admissions to Chaophrayayommarat hospital caused by adverse drug reactions (ADRs) during May 2024 – March 2025. The prevalence of ADRs, their economic burden from the hospital perspective, severity, and preventability were assessed using standard criteria. Results: Out of 23,247 hospital admissions, 217 ADRA have been identified. The incidence of ADRA was 0.93% (95% CI 0.81-1.06). Antimicrobial agents related ADRs, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Anti-diabetic were the commonest ADRs seen accounting for 27.18, 13.36, and 14.28 events respectively out of the 217 events. Out of 217 events, 143 (65.89%) were identified as the potential preventability of ADRA. The total cost for 217 patients with ADRA admitted to Chaophrayayommarat hospitals was estimated at 1,555,206 Bath. The mean total cost per patient with ADRA was estimated at 7,167 ± 4193 Bath. Conclusion: In addition to the increase in the number of expensive drugs, the ageing population and polypharmacy, the economic impact of ADRA weighs on healthcare spending. It should be emphasized that in most ADRA, medications were contributory reason of hospital admissions and that benefits and risks have to be carefully balanced.
References
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34. Oshikoya KA, Chukwura H, Njokanma OF, Senbanjo IO, Ojo I. Incidence and cost estimate of treating pediatric adverse drug reactions in Lagos, Nigeria. Sao Paulo Med J. 2011;129(5):317-323.
35. Patel KJ, Kedia MS, Bajpai D, Mehta SS, Kshirsagar NA, Gogtay NJ. Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral center: a prospective study. BMC Clin Pharmacol. 2007;7:8.
36. Pattanaik S, Dhamija P, Malhotra S, Sharma N, Pandhi P. Evaluation of cost of treatment of drug-related events in a tertiary care public sector hospital in Northern India: a prospective study. Br J Clin Pharmacol. 2009;67(3):363-369.
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38. Rottenkolber D, Schmiedl S, Rottenkolber M, Farker K, Saljé K, Mueller S, et al. Adverse drug reactions in Germany: direct costs of internal medicine hospitalizations. Pharmacoepidemiol Drug Saf. 2011;20(6):626-634.
2. Riedl MA, Casillas AM. Adverse drug reactions: types and treatment options. Am Fam Physician. 2003;68(9):1781-1791.
3. Harmark L, van Grootheest AC. Pharmacovigilance: methods, recent developments and future perspectives. Eur J Clin Pharmacol. 2008;64(8):743-752.
4. World Health Organization. The importance of pharmacovigilance. Geneva: World Health Organization; 2002.
5. World Health Organization. WHO pharmacovigilance indicators: a practical manual for the assessment of pharmacovigilance systems. Geneva: World Health Organization; 2015.
6. Suke SG, Kosta P, Negi H. Role of pharmacovigilance in India: an overview. Online J Public Health Inform. 2015;7(2):e223.
7. Sawanpanyalert P, Suwankesawong W. Health products vigilance in Thailand: past, present and future. J Health Sci Thai. 2024;25(3):444-455.
8. Li R, Curtain C, Bereznicki L, Zaidi STR. Community pharmacists’ knowledge and perspectives of reporting adverse drug reactions in Australia: a cross-sectional survey. Int J Clin Pharm. 2018;40(4):878-889.
9. Yu YM, Shin WG, Lee JY, Choi SA, Jo YH, Youn SJ, et al. Patterns of adverse drug reactions in different age groups: analysis of spontaneous reports by community pharmacists. PLoS One. 2015;10(7):e0132916.
10. Thai Food and Drug Administration, Health Product Vigilance Center. Statistic of adverse events during 1984–2019 [Internet]. Nonthaburi: Thai FDA; 2019 [cited 2025 Oct 9].
11. Akaleephan C, Kaewpanukrunsi W, Limwattananon C. Adverse drug reaction monitoring program. J Health Sci. 2004;13(2):350-
361.
12. Chiewchantanakit D. Study of adverse drug reactions at Queen Sirikit National Institute of Child Health [dissertation]. Bangkok: Mahidol University; 2000.
13. Siltharm C, Pattanaprateep O, Pongcharoensuk P, Jeanpeerapong N, Thavorncharoensap M. Detection of adverse drug reaction (ADR)-related hospital admissions: a pilot study using administrative database for ADR monitoring in Thailand. Pharm Sci Asia. 2017;44(3):142-153.
14. Tragulpiankit P, Pummangura C, Luscombe DK, Kaojarern S, Wananukul W, Montakantikul P, et al. Prevention of adverse drug reactions in hospitalised patients by pharmacist participation at a large teaching hospital in Thailand. Drug Saf. 2005;28(10):931-
944.
15. Sittiphan S, Lim A, Khurram H, Dureh N, Dittakan K. Epidemiology of reported serious adverse drug reactions due to anti- infectives using nationwide database of Thailand. PLoS One. 2025;20(2):e0318597.
16. Kampichit S, Srisuriyachanchai W, Pratipanawatr T, Jarernsiripornkul N. Accuracy in patient-reported adverse drug reactions and their recognition: a mixed-methods study. Int J Clin Pharm. 2024;46(2):401-410.
17. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255-1259.
18. Rajakannan T, Mallayasamy S, Rajesh V, Muralidhar V, Smitha P, Sudha V. Development of indicators for identifying adverse drug events in an Indian tertiary care teaching hospital. Drug Healthc Patient Saf. 2010;2:95-100.
19. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-245.
20. Rawlins MD, Thompson JW. Pathogenesis of adverse drug reactions. In: Davies DM, editor. Textbook of adverse drug reactions. Oxford: Oxford University Press; 1977. p. 10.
21. Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm. 1992;49(9):2229-2232.
22. WHO Collaborating Centre for Drug Statistics Methodology. ATC classification system [Internet]. Oslo: WHO Collaborating Centre for Drug Statistics Methodology; [cited 2025 Jan 12].
23. Uppsala Monitoring Centre. WHO adverse reaction terminology. Uppsala: Uppsala Monitoring Centre; 2007.
24. Ngamjarus C, Chongsuvivatwong V, McNeil E. n4Studies: sample size calculation for an epidemiological study on a smart device. Siriraj Med J. 2016;68(3):160-170.
25. Thai Food and Drug Administration, Health Product Vigilance Center. Spontaneous reports of adverse drug reactions 2022 [Internet]. Nonthaburi: Thai FDA; 2022 [cited 2023 Dec 23].
26. Batel Marques F, Penedones A, Mendes D, Alves C. A systematic review of observational studies evaluating costs of adverse drug reactions. Clinicoecon Outcomes Res. 2016;8:413-426.
27. Formica D, Sultana J, Cutroneo PM, Lucchesi S, Angelica R, Crisafulli S, et al. The economic burden of preventable adverse drug reactions: a systematic review of observational studies. Expert Opin Drug Saf. 2018;17(7):681-695.
28. Gautier S, Bachelet H, Bordet R, Caron J. The cost of adverse drug reactions. Expert Opin Pharmacother. 2003;4(3):319-326.
29. Bordet R, Gautier S, Le Louet H, Dupuis B, Caron J. Analysis of the direct cost of adverse drug reactions in hospitalized patients. Eur J Clin Pharmacol. 2001;56(12):935-941.
30. Lagnaoui R, Moore N, Fach J, Longy-Boursier M, Bégaud B. Adverse drug reactions in a department of systemic diseases- oriented internal medicine: prevalence, incidence, direct costs and avoidability. Eur J Clin Pharmacol. 2000;56(2):181-186.
31. Jolivot PA, Pichereau C, Hindlet P, Hejblum G, Bigé N, Maury E, et al. An observational study of adult admissions to a medical ICU due to adverse drug events. Ann Intensive Care. 2016;6(1):9.
32. Goettler M, Schneeweiss S, Hasford J. Adverse drug reaction monitoring cost and benefit considerations part II: cost and preventability of adverse drug reactions leading to hospital admission. Pharmacoepidemiol Drug Saf. 1997;6 Suppl 3:S79-S90.
33. Moore N, Lecointre D, Noblet C, Mabille M. Frequency and cost of serious adverse drug reactions in a department of general medicine. Br J Clin Pharmacol. 1998;45(3):301-308.
34. Oshikoya KA, Chukwura H, Njokanma OF, Senbanjo IO, Ojo I. Incidence and cost estimate of treating pediatric adverse drug reactions in Lagos, Nigeria. Sao Paulo Med J. 2011;129(5):317-323.
35. Patel KJ, Kedia MS, Bajpai D, Mehta SS, Kshirsagar NA, Gogtay NJ. Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral center: a prospective study. BMC Clin Pharmacol. 2007;7:8.
36. Pattanaik S, Dhamija P, Malhotra S, Sharma N, Pandhi P. Evaluation of cost of treatment of drug-related events in a tertiary care public sector hospital in Northern India: a prospective study. Br J Clin Pharmacol. 2009;67(3):363-369.
37. Osanlou R, Walker L, Hughes DA, Burnside G, Pirmohamed M. Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions. BMJ Open. 2022;12(7):e055551.
38. Rottenkolber D, Schmiedl S, Rottenkolber M, Farker K, Saljé K, Mueller S, et al. Adverse drug reactions in Germany: direct costs of internal medicine hospitalizations. Pharmacoepidemiol Drug Saf. 2011;20(6):626-634.
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Jun 20, 2026
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1.
The burden cost of adverse drug reaction related to admission at Chaophrayayommarat hospital. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-8. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3634
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Author Biography
Monton Tanabodee, MD, Division of dermatology, Department of Internal Medicine, Chaophrayayommarat hospital.
0
How to Cite
1.
The burden cost of adverse drug reaction related to admission at Chaophrayayommarat hospital. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-8. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3634