Drug Safety

, Volume 35, Issue 12, pp 1171–1182 | Cite as

Global Patterns of Adverse Drug Reactions Over a Decade

Analyses of Spontaneous Reports to VigiBase™
  • Lise Aagaard
  • Johanna Strandell
  • Lars Melskens
  • Paw S. G. Petersen
  • Ebba Holme Hansen
Original Research Article


Background: Although systems to collect information about suspected adverse drug reactions (ADRs) were established in many countries and by the WHO in the 1960s, few studies have examined reported ADRs related to national income.

Objective: The aim of the study was to characterize ADRs reported to the WHO-ADR database, VigiBase™, and to relate data to national income.

Methods: We analysed ADR reports submitted to VigiBase™ from 2000 to 2009 with respect to reporting rate, age and sex of patient, type, seriousness and medications. Reports were also analysed with respect to national income level, classified in accordance with the World Bank definition: low, lower-middle, upper-middle and high.

Results: We analysed 1 359067 ADR reports including 3 013 074 ADRs. Overall, 16% of reports were serious and 60% were reported for females. High-income countries had the highest ADR reporting rates (range 3–613 reports/million inhabitants/year) and low-income countries the lowest (range 0–21). Distribution of ADRs across income groups with respect to age group, seriousness and sex was non-significant. Overall, the majority of ADRs were reported for nervous system medications, followed by cardiovascular medicines. Low-income countries reported relatively more ADRs for anti-infectives for systemic use than high-income countries, and high-income countries reported more ADRs for antineoplastic and immunomodulating agents than lower-income groups.

Conclusion: This study showed that high-income countries had the highest ADR reporting rates and low-income countries the lowest, with large variations across countries in each group. Significant differences in ADR reporting rates were only found for ADRs of the type ‘skin and subcutaneous tissue disorders’ and for the therapeutic groups ‘antiinfectives for systemic use’ and ‘antineoplastic and immunomodulation agents’. To strengthen ADR reporting rates, especially in low-income countries, more research is needed about the impact of organizational structures and economic resources of national pharmacovigilance centres and ADR reporting practices on the large variations in ADR reporting rates within income groups.


Adverse Drug Reaction Anatomical Therapeutic Chemical Artesunate Therapeutic Group Adverse Drug Reaction Reporting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We would like to thank the WHO UMC for making data available. The authors are indebted to the national centres that contribute data. The opinions and conclusions in this study are not necessarily those of the various centres, nor of the WHO.

L. Aagaard, J. Strandell, L. Melskens, P.S.G. Petersen and E. Holme Hansen designed the study, analysed data and wrote the first version of the manuscript. L. Melskens and P.S.G. Petersen collected the data. All authors saw and approved the final version of the manuscript.

No sources of funding were used to assist in the preparation of this study, and the authors have identified no financial or other conflicts of interest with respect to the content of this article.

The MedDRA® trademark is owned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) on behalf of the ICH.


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Copyright information

© Springer International Publishing AG 2012

Authors and Affiliations

  • Lise Aagaard
    • 1
    • 2
    • 3
  • Johanna Strandell
    • 4
    • 5
  • Lars Melskens
    • 6
  • Paw S. G. Petersen
    • 6
  • Ebba Holme Hansen
    • 2
    • 3
    • 6
  1. 1.Institute of Public Health, Clinical Pharmacology, Faculty of Health SciencesUniversity of Southern DenmarkOdense CDenmark
  2. 2.FKL-Research Centre for Quality in Medicine UseCopenhagenDenmark
  3. 3.Danish Pharmacovigilance Research Project (DANPREP)CopenhagenDenmark
  4. 4.Uppsala Monitoring CentreUppsalaSweden
  5. 5.Department of Drug Research/Clinical PharmacologyLinköping UniversityLinköpingSweden
  6. 6.Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark

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