Pharmaceutical Drug Disaster

     Pharmaceutical drugs do much more damage than illegal drugs.

     From Medscape Pharmacists, 2001

     "Medication Errors
     The Role of the Community Pharmacist in Identifying, Preventing, and Resolving Drug-Related Problems
Jennifer Cerulli, PharmD, BCPS

  It is estimated that 3% to 10% of hospital admissions are a consequence of drug-related morbidity and mortality, and half of those admissions are preventable.  
  In 1995, the direct annual cost spent on preventable drug-related morbidity and mortality in the US ambulatory population was estimated to be $76.6 billion dollars; in 2000, the amount exceeded $177.4 billion. These preventable negative patient outcomes and their associated costs have caught the attention of patients, healthcare professionals, and governmental agencies. Drug-related morbidity and mortality often are preceded by a drug-related problem. Drug-related problems have been defined as events or circumstances involving a patient's drug treatment that actually, or potentially, interfere with the achievement of an optimal outcome.  Most drug-related problems can be assigned to 1 of 8 categories:

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     The failed anti-recreational-drug Federal Police State activities in the US cost ~ $12 billion a year with no measure of any "effectiveness", and the drug-offense incarceration rate for the US is the highest of any industrialized country: more than 1/2% of the entire US population.
     Ignoring the iatrogenic pharmaceutical drug deaths, also much higher than recreational drug deaths, the $177 billion lost yearly in the pharmaceutical drug disaster, however, costs ~ 15 times as much, and indicates that the wrong people are in jail.

Drug-Related Morbidity and Mortality: Updating the Cost-of-Illness Model
J Am Pharm Assoc. 2001;41:192-9.
Frank R. Ernst and Amy J. Grizzle

  Objective: To update the 1995 estimate of $76.6 billion for the annual cost of drug-related morbidity and mortality resulting from drug-related problems (DRPs) in the ambulatory setting in the United States to reflect current treatment patterns and costs.
  Design: For this study, we employed the decision-analytic model developed by Johnson and Bootman. We used the model's original design and probability data, but used updated cost estimates derived from the current medical and pharmaceutical literature. Sensitivity analyses were performed on cost data and on probability estimates.
  Setting: Ambulatory care environment in the United States in the year 2000. Patients and Other Participants: A hypothetical cohort of ambulatory patients. Main Outcome Measures: Average cost of health care resources needed to manage DRPs.
  Results: As estimated using the decision-tree model, the mean cost for a treatment failure was $977. For a new medical problem, the mean cost was $1,105, and the cost of a combined treatment failure and resulting new medical problem was $1,488. Overall, the cost of drug-related morbidity and mortality exceeded $177.4 billion in 2000. Hospital admissions accounted for nearly 70% ($121.5 billion) of total costs, followed by long-term-care admissions, which accounted for 18% ($32.8 billion). Conclusion: Since 1995, the costs associated with DRPs have more than doubled. Given the economic and medical burdens associated with DRPs, strategies for preventing drug-related morbidity and mortality are urgently needed.
  Frank R. Ernst, PharmD, is an Eli Lilly and Company Health Outcomes Fellow; Amy J. Grizzle, PharmD, is assistant director, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson. Correspondence: Frank R. Ernst, PharmD, College of Pharmacy, University of Arizona, P.O. Box 210207, Tucson, AZ 85721-0207. Fax: 520-626-3386. E-mail: Ernst@Pharmacy.Arizona.edu.