These costs are expected to be an underestimation, as most ADEs occurring in primary care do not lead to hospitalisation, but still result in an elevated need for health care. These costs are not taken into account. Health care costs related to ADEs in this base case totaled 816 million Euros, mean costs per case were 381 Euros. All the cost studies that were identified in the literature, including the ones summarised in the table, argued that the figures are likely to be an underestimation of the direct costs.