Adverse drug events (ADEs) are serious adverse reactions experienced by a patient as a result of exposure to a medication. These events are a major problem in clinical practice and are a significant economic burden for health systems. These adverse reactions limit the success of medicines and can even lead to the death of patients.
ADEs are one of the most common preventable adverse events in all settings of care, primarily due to the widespread use of prescription and nonprescription medications [1]. Each year, ADEs account for nearly 1.3 million emergency department visits and 350,000 hospitalizations [2]. Additionally, 5% of hospitalized patients experience an ADE, making them one of the most common types of inpatient errors [3]. Leveraging pharmacogenomics to identify the DNA variants associated with ADEs can help personalize prescriptions and combat the economic burden of ADEs.
Causes of adverse drug events
The development of ADEs involves various pharmacological, immunological, and genetic factors. Many ADEs occur as a result of the extension of the desired pharmacologic effects of a medication. This often occurs due to the variability in the pharmacokinetics and pharmacodynamics among patients.
Factors that predispose an individual to an ADE may include dose, drug formulation, pharmacokinetic or pharmacodynamic abnormalities, and drug interactions. Other factors that can increase the possibility of the occurrence of ADE include age, gender, polypharmacy (multiple drugs), disease state, genetic factors, dosage, past history of ADR or allergy, and more.
The cost of adverse drug events
The impact and management of ADEs are complex and costly. ADEs can increase costs due to factors such as increased hospitalization, prolonged hospital stays, and additional clinical investigations in more severe cases. Additionally, ADEs can trigger prescription cascades, which is when new medications are prescribed for conditions that are a result of another medication, which is often an unrecognized adverse drug reaction. This not only increases the cost of pharmacotherapy but also increases the risk of further ADEs.
The extended duration of hospital stay and outpatient care as a result of ADRs are a source of financial burden. ADEs in a hospital setting incur direct financial costs related to wages, disposable goods, and medications. There are also indirect costs for patients and their caregivers such as missed days from work and comorbidities related to an ADR episode. ADEs that occur during hospitalization are costly for hospitals to treat, with expenses costing between $1.56 and $5.6 billion annually [4]. The individual cost of a significant or life-threatening ADE has been estimated to range between $2,852 and $8,116 in community hospitals [5]. These costs are likely to be conservative estimates, as they did not include malpractice or litigation costs, or the costs of injuries to patients.
How myPGx can help
ADEs are a significant source of economic burden on healthcare systems, patients, and their caregivers. Randomized clinical trials on their own are not enough to detect and assess the frequency of ADEs. Although ADEs are highly prevalent and costly, they are also often predictable and preventable. Pharmacogenomic testing is valuable not only in optimizing treatment efficacy, but can also aid in the prediction and explanation of ADEs. LetsGetChecked’s pharmacogenomic solution, myPGx, can help predict how patients may respond to drugs based on their unique genetic profile, lowering the risk of ADEs.
References
- https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
- https://www.cdc.gov/medicationsafety/adult_adversedrugevents.html
- https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
- https://www.sciencedirect.com/science/article/abs/pii/S0378608019300583
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646874/
