Cost-effectiveness of an electronic medication ordering and administration system in reducing adverse drug events

Objectives Adverse drug events (ADEs) are common and cause significant morbidity and mortality. Patient safety groups advocate the implementation of electronic medication order entry systems to reduce ADEs. However, these systems are costly, and there are limited data on their effectiveness. We conducted a study to examine the costs of introducing an electronic medication ordering and administration system and its potential impact on reducing ADEs. Methods An incremental cost-effectiveness analysis was performed comparing an electronic medication ordering and administration system to the standard system used at a large health care institution over a 10-year time horizon. Estimates of effect were obtained from the literature. Cost data were obtained from a health care institution in Toronto, Canada. Results The incremental cost-effectiveness of the new system was $12 700 (USD) per ADE prevented. The cost-effectiveness was found to be sensitive to the ADE rate, to the effectiveness of the new system, the cost of the system, and costs due to possible increase in doctor workload. Conclusions An electronic medication order entry and administration system could improve care by reducing adverse events. Unfortunately there are limited data on effectiveness of these systems at reducing ADEs. Further research is required to determine more precisely the potential economic benefit of this technology.