The Costs of Benzodiazepine-Associated Hospital-Treated Fall Injuries in the EU: A Pharmo Study



To estimate the hospitalisation costs of accidental fall injuries in the EU resulting from the use of benzodiazepines.


Risk and exposure data were obtained from the Dutch Pharmo system, a population-based register of drug-dispensing records and hospital records. The population attributable risk (PAR) was calculated using the age-specific prevalence estimates of benzodiazepine use and the corresponding relative risk (RR), obtained from a case-control study in community-dwelling inhabitants over 55 years of age in defined areas of The Netherlands covering the period 1985–2000. Annual hospitalisation costs of benzodiazepine-related fall injuries were based on the age-specific PARs and extrapolated to the European population using accident and demographic data of the EU. All analyses were performed from the perspective of a third-party payer.


Fall injuries in the study population were significantly associated with benzodiazepine use (RR 1.6, 95% CI 1.4–1.7), especially in those aged over 85 years (RR 3.6, 95% CI 2.9–4.5). The total annual hospital direct medical costs in 2000 of fall-related injuries attributable to benzodiazepine use were €1.8 billion (95% CI €1.5-2.2 billion) in the EU.


The estimated costs of hospitalisations of accidental-fall injuries related to benzodiazepine use in the EU varied between €1.5 and €2.2 billion each year. More than 90% of these costs were in the elderly, with hip fractures as the major contributor. Discontinuing benzodiazepines in the elderly and/or substituting them with other drugs not associated with the risk of falls in the elderly will to a large extent prevent these accidents.

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We thank all pharmacists, medical specialists and staff members of the hospitals participating in the Pharmo system.

This study was supported by an unrestricted grant from Pfizer International, New York, USA.

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Correspondence to Dr Wim G. Goettsch.

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Panneman, M.J.M., Goettsch, W.G., Kramarz, P. et al. The Costs of Benzodiazepine-Associated Hospital-Treated Fall Injuries in the EU: A Pharmo Study. Drugs Aging 20, 833–839 (2003).

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  • Community Pharmacy
  • Population Attributable Risk
  • Total Treatment Cost
  • Hospital Discharge Record
  • Fall Injury