Besides their potential effectiveness, CPOE/CDSS systems are costly [12]. On the other hand, MEs and pADEs are costly as well [4–6]. With regard to a rational spending of the available healthcare budget, it is essential to study the balance between units of health gained, and the costs that need to be invested in order to achieve these effects. At present, several studies have been performed on the costs and cost-effectiveness of CPOE/CDSS, but the evidence on cost-effectiveness is limited, especially in multicenter settings. In the most recent review [12] six studies on CPOE were included as well as five stud- ies on medication management systems. Of the six studies on CPOE only two examined cost-benefit or cost-effectiveness and none of the studies were performed in multiple settings. Of the medication management system studies, none were on cost-benefit or cost-effectiveness and one was performed in multiple settings [12].
The one study on the effect of CPOE on cost-effectiveness mentioned above [13] showed a high cost-effectiveness ratio, which means that the additional costs that have to be invested to gain one unit of additional effect (e.g. reduction in MEs or pADEs) are high: the incremental cost-effectiveness ratio was $12,700 per ADE averted. Study design, measures of effect, set- ting and healthcare system, however, limit the generalizability of these results. In addition, for the European situation we know of no previous cost effectiveness studies on this subject.
Therefore, the aim of the present study was to evaluate the balance between the effects and costs of CPOE compared to a traditional paper-based ordering system.