How to collect and analyze costs associated with adverse drug events

Welcome to the world of practical pharmacoeconomics! This is the first edition of a monthly column that will appear in Formulary. Each month, this column will discuss how you can use pharmacoeconomic techniques to solve problems that have both clinical and financial repercussions. Although pharmacoeconomic ''theory'' will be discussed from time to time and references provided when necessary, this column will be devoted to practical pharmacoeconomic issues faced by your pharmacy department of P & T Committee. What is pharmacoeconomics? I think of it as an assortment of techniques or models used to help one select the most cost-effective drug therapies among alternatives. Whichever model is chosen, it should consider both the effectiveness of the therapy (which might include drugs, pathways, or clinical services) and the cost of providing that therapy. It should be remembered that relevant costs change every time a new analysis is performed, and that the definition of effectiveness could be stated in terms of dollars saved, adverse events avoided, or end points that are difficult to value, such asa life saved. A pharmacoeconomic analysis enables one to allocate scarce resources to those areas that provide that greatest return, ie, provide ''the biggest band for the buck.'' Some topics to be discussed in future columns include how to use pharmacoeconomics to decide which drugs to add to the formulary, using pharmacoeconomics to determine whether or not to add a new clinical service, how to select the most appropriate drugs to add to a disease state pathway or protocol orders, and how to convert an efficacy study into a cost-efficacy study. If you have a specific question you would like to see addressed in this column, please submit it (see instructions at end of article). This month's column-the first of a two-part series-examines how to calculate and analyze the costs associated with adverse drug events or reactions (ADEs or ADRs). Next month's column will focus on how to select the combination of interventions and ADE categories that will result in the greatest net benefits (benefits less costs) to the institution.