Healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions

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http://hdl.handle.net/10138/340532

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Kuula , L S M , Backman , J & Blom , M 2022 , ' Healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions ' , Pharmacology Research & Perspectives , vol. 10 , no. 2 , 00931 . https://doi.org/10.1002/prp2.931

Title: Healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions
Author: Kuula, Laura S.M.; Backman, Janne; Blom, Marja
Contributor organization: Division of Pharmacology and Pharmacotherapy
HUSLAB
Department of Clinical Pharmacology
Clinicum
Divisions of Faculty of Pharmacy
Pharmacoeconomics
Date: 2022-04
Language: eng
Number of pages: 12
Belongs to series: Pharmacology Research & Perspectives
ISSN: 2052-1707
DOI: https://doi.org/10.1002/prp2.931
URI: http://hdl.handle.net/10138/340532
Abstract: The aim of this study was to estimate healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions in Finland from 2008 to 2019. Serious adverse reaction types were identified from the Finnish Pharmaceutical Insurance Pool's pharmaceutical injury claims and the Finnish Medicines Agency's Adverse Reaction Register. A decision tree model was built to predict costs and mortality associated with serious adverse drug reactions (ADR). Severe clostridioides difficile infections, severe cutaneous adverse reactions, tendon ruptures, aortic ruptures, and liver injuries were included as serious adverse drug reactions in the model. Direct healthcare costs of a serious ADR were based on the number of reimbursed fluoroquinolone prescriptions from the Social Insurance Institution of Finland's database. Sensitivity analyses were conducted to address parameter uncertainty. A total of 1 831 537 fluoroquinolone prescriptions were filled between 2008 and 2019 in Finland, with prescription numbers declining 40% in recent years. Serious ADRs associated with fluoroquinolones lead to estimated direct healthcare costs of 501 938 402 (sic), including 11 405 ADRs and 3,884 deaths between 2008 and 2019. The average mortality risk associated with the use of fluoroquinolones was 0.21%. Severe clostridioides difficile infections were the most frequent, fatal, and costly serious ADRs associated with the use of fluoroquinolones. Although fluoroquinolones continue to be generally well-tolerated antimicrobials, serious adverse reactions cause long-term impairment to patients and high healthcare costs. Therefore, the risks and benefits should be weighed carefully in antibiotic prescription policies, as well as with individual patients.
Subject: 317 Pharmacy
adverse drug reactions
antibiotics
costs
decision analysis
FULMINANT CLOSTRIDIUM-DIFFICILE
ACUTE LIVER-INJURY
CLINICAL-FEATURES
SAFETY PROFILE
RISK
MOXIFLOXACIN
INFECTION
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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