ClinicoEconomics and Outcomes Research (Sep 2022)

Costs Associated with Adverse Drug Reactions Among HIV/TB Patients in Thailand

  • Rochanathimoke O,
  • Tragulpiankit P,
  • Turongkaravee S,
  • Jittikoon J,
  • Udomsinprasert W,
  • Chaikledkeaw U

Journal volume & issue
Vol. Volume 14
pp. 587 – 599

Abstract

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Onwipa Rochanathimoke,1 Pramote Tragulpiankit,2 Saowalak Turongkaravee,1 Jiraphun Jittikoon,3 Wanvisa Udomsinprasert,3 Usa Chaikledkeaw1,4 1Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 2Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 3Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 4Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, ThailandCorrespondence: Usa Chaikledkeaw, Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Ratchathewi, Bangkok, 10400, Thailand, Email [email protected]: To assess the direct and indirect costs associated with adverse drug reactions (ADRs) in patients receiving treatment regimens for human immunodeficiency virus (HIV) infection and tuberculosis (TB) in selected Thai hospitals.Patients and Methods: This was a retrospective study conducted between October 2014 and September 2019 at three public hospitals in Thailand. Data were obtained from a medical database and spontaneous ADR reporting system of each study site. The out-of-pocket health payments and indirect costs were determined via interviewing. All costs were updated to 2021.Results: A total of 432 eligible patients who experienced ADRs due to HIV and TB treatment, and 93 patients were interviewed to determine direct non-medical and indirect costs. The average direct medical cost for ADR was USD 5.65 for mild cases, USD 156.54 for moderate cases, and USD 1,242.45 for severe cases. For direct non-medical costs, the average cost per episode was USD 27.29 in mild ADR, USD 70.86 in moderate ADR and USD 270.66 in severe ADR. The indirect cost incurred in each mild, moderate and severe ADR was USD 41.86, USD 89.34, and USD 552.60, respectively. The Stevens-Johnson syndrome (SJS) had the highest management costs.Conclusion: ADRs associated with anti-tuberculosis drugs and antiretroviral drugs seem to have a substantial economic impact from a societal perspective. These findings would be useful for increasing awareness and encouraging early avoidance of ADRs.Keywords: cost, adverse drug reaction, HIV, TB, Thai

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