Economic Impact of Aminoglycoside Toxicity and its Prevention Through Therapeutic Drug Monitoring

Richard Slaughter and Diane Cappelletty
Additional contact information
Richard Slaughter: Department of Pharmacy Practice, College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan, USA
Diane Cappelletty: Department of Pharmacy Practice, College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan, USA

PharmacoEconomics, 1998, vol. 14, issue 4, pages 385-394

Abstract: Therapeutic drug monitoring (TDM) of aminoglycoside antibacterials with the goal of minimising toxicity and maximising effectiveness has become routine. Successful management of serious infections requires the ability to achieve therapeutic peak concentrations, while maintaining low trough concentrations will assist in avoiding nephrotoxicity. Reported nephrotoxicity rates range from 1.7 to 58% and depend on the definition used, the patient group studied, concomitant drug therapy used and whether TDM services have been provided. TDM services have been shown to reduce aminoglycoside nephrotoxicity. The costs of providing TDM averages $US301.87 (1997 values) per patient and the cost for each use of nephrotoxicity is estimated at $US4583 (1997 values). In order for the costs of providing a TDM service to 100 patients ($US30 187) to be offset by cost savings due to decreasing nephrotoxicity, the service would need to be able to reduce nephrotoxicity by 6.6%, resulting in a saving of $US30 248. The ability to achieve this saving is dependent on the characteristics of the population in which aminoglycoside therapy is used. In populations where high rates of nephrotoxicity (e.g. >15%) would be expected, TDM services are cost justified. In populations where nephrotoxicity is low (e.g. <5%), TDM service is not justified for this purpose. In order to provide a cost-efficient approach to TDM, resources should be focused on providing service to high risk patient groups.

Keywords: Reviews-on-treatment; Aminoglycosides; Kidney-disorders; Adverse-reaction-monitoring; Pharmacoeconomics; Cost-analysis (search for similar items in EconPapers)
JEL-codes: C D I Z I1 I19 I18 I11 (search for similar items in EconPapers)
Date: 1998
References: Add references at CitEc
Citations Track citations by RSS feed

Downloads: (external link)
http://pharmacoeconomics.adisonline.com/pt/re/phe/ ... -199814040-00005.pdf (application/pdf)
http://pharmacoeconomics.adisonline.com/pt/re/phe/ ... -199814040-00005.htm (text/html)
Pay per view

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: http://EconPapers.repec.org/RePEc:wkh:phecon:v:14:y:1998:i:4:p:385-394

Access Statistics for this article

PharmacoEconomics is edited by Christopher I. Carswell, MSc, MRPharmS

More articles in PharmacoEconomics from Springer Healthcare | Adis
Series data maintained by Dave Dustin ().