Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting
Open accessAbstract
Objectives To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. Methods An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. Results The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. Conclusions The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates.
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Despite increased costs, potential cost savings of avoided MAEs of 258 avoided administration errors, 178 procedural errors, and 27 clinical errors per 100 patient-days could balance the incremental costs.
“However, Risør et al. added that despite increased costs, potential cost savings of avoided MAEs of 258 avoided administration errors, 178 procedural errors, and 27 clinical errors per 100 patient-days could balance the incremental costs.47”
From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [47]
Calculations of ADC implementation cost per 100 patient days (€1117 per 100 patient-days) reported to be higher than that of conventional medication management (€615 per 100 patient-days), corresponding to incremental costs of €502 per 100 patient-days.
“Calculations of ADC implementation cost per 100 patient days (€1117 per 100 patient-days) reported to be higher than that of conventional medication management (€615 per 100 patient-days), corresponding to incremental costs of €502 per 100 patient-days.47”
From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [47]
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Jung, Y. Y., Walsh, Á., Patel, J., & Lai, K. (2025) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2025.100599 · Cited by 7 · see citing works
- Authors
- Risør, B. W., Lisby, M., & Sørensen, J.
- Affiliations
- University of Southern Denmark (DK)
- Aarhus University Hospital (DK)
- Royal College of Surgeons in Ireland (IE)
- Corresponding author
- Risør, Bettina Wulff
- Venue
- Value in Health
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 20
- Issue
- 7
- Pages
- 886-893
- ISSN
- 1098-3015 (ISSN-L)
- OpenAlex
- W2545018975
- Cited by
- 43
- References
- 2
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 4 · 2019: 5 · 2018: 2 · 2017: 3
- FWCI
- 6.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Value in Health (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- medication administration errors, medication errors, cost-effectiveness, before-after study, error reduction, hospital costs
- MeSH terms
- Automation, Cost-Benefit Analysis, Costs and Cost Analysis, Denmark, Hospitals, Humans, Medication Errors, Medication Systems, Hospital, Prospective Studies, Time Factors, Logistic Models
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