ECONOMIC-IMPACT OF DIGOXIN TOXICITY

The costs of digoxin toxicity to the US healthcare system have not bee n previously reported. Therefore, the 1994 database of the US Universi ty Health-System Consortium (UHC) was searched fur cases of digoxin to xicity using the International Classification of Diseases (9th edition ) [ICD-9] codes. In addition, the medical records of 17 patients admit ted to the University of Illinois Hospital from September 1994 to July 1995 with a diagnosis of digoxin toxicity were also reviewed. Of the 17 patients, 14 were admitted with a primary diagnosis of digoxin toxi city. Causes of digoxin toxicity were worsening renal function (6 pati ents), excessive dosage prescribed (4 patients), excessive dosage self -administered (2 patients), multiple prescriptions (2 patients), accid ental ingestion (1 patient), drug-drug interaction (1 patient) and unk nown (1 patient). Digoxin toxicity could have been prevented in 9 (53% ) Of the 17 patients. The mean length of stay in the hospital as a res ult of digoxin toxicity was 3.3 +/- 1.2 days. The mean laboratory cost associated with digoxin toxicity was $US275.54 +/- $US106.57 and the mean hospital bed cost was $US3781.92 +/- $US2572.22. The mean overall cost associated with digoxin toxicity was $US4087.05 +/- $US2659.76. There was a significant correlation between the total cost associated with digoxin toxicity and the serum digoxin concentration on admission (r = 0.73, p < 0.01). From the UHC database, a total of 836 cases of digoxin toxicity in 56 hospitals were identified. This represented the occurrence of digoxin toxicity in 0.07% of all patients admitted to t hese US academic hospitals. Digoxin toxicity results in considerable c osts to the healthcare system. Most cases can be considered readily pr eventable with proper patient counselling and education.