title: Health care use and costs of adverse drug events emerging from outpatient treatment in Germany: a modelling approach.
abstract: BACKGROUND
  This study's aim was to develop a first quantification of the frequency and costs of adverse drug events (ADEs) originating in ambulatory medical practice in Germany.
  
  
  METHODS
  The frequencies and costs of ADEs were quantified for a base case, building on an existing cost-of-illness model for ADEs. The model originates from the U.S. health care system, its structure of treatment probabilities linked to ADEs was transferred to Germany. Sensitivity analyses based on values determined from a literature review were used to test the postulated results.
  
  
  RESULTS
  For Germany, the base case postulated that about 2 million adults ingesting medications have will have an ADE in 2007. Health care costs related to ADEs in this base case totalled 816 million Euros, mean costs per case were 381 Euros. About 58% of costs resulted from hospitalisations, 11% from emergency department visits and 21% from long-term care. Base case estimates of frequency and costs of ADEs were lower than all estimates of the sensitivity analyses.
  
  
  CONCLUSIONS
  The postulated frequency and costs of ADEs illustrate the possible size of the health problems and economic burden related to ADEs in Germany. The validity of the U.S. treatment structure used remains to be determined for Germany. The sensitivity analysis used assumptions from different studies and thus further quantified the information gap in Germany regarding ADEs.
  
  
  CONCLUSIONS
  This study found costs of ADEs in the ambulatory setting in Germany to be significant. Due to data scarcity, results are only a rough indication.
authors.affiliation: Institute for Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg 85764, Germany. r.stark@helmholtz-muenchen.de
authors.forename: Renee G
authors.initials: RG
authors.lastname: Stark
authors.forename: Jürgen
authors.initials: J
authors.lastname: John
authors.forename: Reiner
authors.initials: R
authors.lastname: Leidl
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D004358:Drug Therapy / Q000191:economics; D064420:Drug-Related Side Effects and Adverse Reactions; D004636:Emergency Service, Hospital / Q000191:economics; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D017721:Hospital Costs / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000191:economics