Economics of Medication Safety, with a Focus on Preventable Harm

Adverse drug reactions can be an important cause of morbidity and mortality and may have significant economic consequences, including the increased use of health services and wider societal costs. We can refer to this as ‘economic burden’. This chapter defines and explores how to quantify the economic burden of adverse drug reactions. Health economists are particularly interested in the avoidable economic burden caused by medication errors. Therefore, this chapter focuses on the avoidable economic burden caused by medication errors. There are three types of evidence required to understand the economic burden of medication errors: the incidence or prevalence of medication errors, the consequences (health and wider effects) of those medication errors, and the resources consumed due to the consequences associated with those medication errors. The challenges around quantifying harm from medication errors are discussed. Strategies which aim to improve patient safety through interventions such as those that change prescribing or monitoring behaviour are often costly, so we need to know if they are effective or cost-effective. This chapter outlines how different economic evaluation approaches can be carried out alongside randomised controlled trials, nonrandomised comparative studies (such as interrupted time series analysis) or as modelling studies. The published evidence around the cost-effectiveness of safety interventions is introduced. The benefits of improved patient safety are not just maximising health, which affects how they are valued by different stakeholders, so this chapter concludes by examining the non-health components of safety intervention outcomes.