Study shows Rx drug misuse costs billions

A new study released in the Journal of the American Pharmaceutical Association (vol. 41, no. 2) estimates that drug misuse costs the economy more than $177 billion each year. And, according to the study, the estimated number of patient deaths resulting from misuse of prescription drugs has increased from 198,000 in 1995 to 218,000 in 2000.

The study, "Drug-Related Morbidity and Mortality: Updating the Cost-of-Illness Model," was conducted by Frank R. Ernst and Amy J. Grizzle of the College of Pharmacy, University of Arizona, Tucson.

According to the authors, "Researchers have shown that costs associated with drug-related problems exceed the expenditures for initial drug therapy; that is, the total cost of drug-related morbidity and mortality exceeds the cost of medications themselves. Drug-related problems are increasingly recognized as a serious and urgent - but largely preventable - medical problem."

Among the most significant drug-related problems identified in the JAPhA study are untreated indication, improper drug selection, subtherapeutic dosage, failure to receive drugs, overdosage, adverse drug reactions, drug interactions and drug use without indication.

The new research updates a 1995 study, published in the Archives of Internal Medicine, that was conducted by Jeffrey A. Johnson and J. Lyle Bootman of the College of Pharmacy, University of Arizona. That study estimated the annual cost of morbidity and mortality resulting from drug-related problems in the ambulatory setting at $76.6 billion.

Cost breakdown

Of the $177.4 billion in yearly costs estimated by the new study, hospital admissions accounted for $121.5 billion (69%), and long-term care admissions represented $32.8 billion (18%). Physician visits accounted for another $13.8 billion (8%), and emergency department visits and additional treatment cost more than $5.8 billion (3%) and $3.5 billion (2%), respectively.

The majority of cost increases appeared to result from hospital and long-term care admission costs, which, according to estimates in the literature, were more than twice the 1995 estimates. The data revealed that the greatest increases in drug-related morbidity and mortality costs were in total hospital admissions (2.6 times), total long-term care admissions (2.3 times) and total physician visits (1.9 times). These events contributed the most to the total cost of illness estimate of $177.4 billion.

The authors of the study wrote, "Drug-related morbidity and mortality continue to pose a serious medical and economic problem for society. More attention should be directed toward developing solutions that reduce preventable morbidity, mortality, and costs associated with drug-related problems." PR