Pin4 Cost-Effectiveness of Drotrecogin Alfa (Activated) in the Treatment of Severe Sepsis in Spain

Ja, Sacristán; Prieto, Luciana; Huete, T.; Artigas, Antonio; Badia, Xavier; Chinn, C; Hudson, Pamela

doi:10.1016/s1098-3015(10)61482-9

Cited by 6 publications

(10 citation statements)

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“…The estimated ICER of the SSC protocol in the present study was better than the estimated ICER for drotrecogin alpha (activated) in Spain (4,435 euros per LYG vs. 13,550 per LGY) [34]. In fact, the ICER of the SSC protocol in Spain compares well with the ICER of many interventions for ICU patients conducted in other developed countries [35] such as drotrecogin alpha (activated) in the US [35] or linezolid compared with vancomycin for the treatment of associated pneumonia due to Staphylococcus aureus in the US [35].…”

Section: Discussioncontrasting

confidence: 75%

Cost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain

et al. 2010

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Context: Severe sepsis is associated with high mortality and increased costs. The 'Surviving Sepsis Campaign' (SSC) protocol was developed as an international initiative to reduce mortality. However, its cost-effectiveness is unknown. Objective: To determine the costeffectiveness of the SSC protocol for the treatment of severe sepsis in Spain after the implementation of an educational program compared with the conventional care of severe sepsis. Design: Observational prospective before-and-after study. Setting: 59 medical-surgical intensive care units located throughout Spain. Patients: A total of 854 patients were enrolled in the pre-educational program cohort (usual or standard care of severe sepsis) and 1,465 patients in the posteducational program cohort (SSC protocol care of severe sepsis). Interventions: The educational program aimed to increase adherence to the SSC protocol. The SSC protocol included pharmacological and medical interventions. Main outcome measures: Clinical (hospital mortality) and economic (health-care resource and treatment costs) outcomes were recorded. A health-care system perspective was used for costs. The primary outcome was incremental cost-effectiveness ratio (ICER). Results: Patients in the SSC protocol care cohort had a lower risk of hospital mortality (44.0% vs. 39.7%, P = 0.04). However, mean costs per patient were 1,736 euros higher in the SSC protocol care cohort (95% CI 114-3,358 euros), largely as a result of increased length of stay. Mean life years gained (LYG) were higher in the SSC protocol care cohort: 0.54 years (95% CI 0.02-1.05 years). The adjusted ICER of the SSC protocol was 4,435 euros per LYG. Nearly all (96.5%) the bootstrap replications were below the threshold of 30,000 euros per LYG. Conclusion: The SSC protocol seems to be a cost-effective option for treating severe sepsis in Spain.

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Section: Discussioncontrasting

confidence: 75%

Cost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain

et al. 2010

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“…73 The remaining 15 studies evaluated the cost-effectiveness of other health-care interventions for the treatment of severe sepsis and septic shock. [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89] Five published abstracts were also identified; however, only limited information on the methods employed was reported and so these studies were excluded from the final literature review. A flow chart of studies included in the final costeffectiveness review is shown in Figure 35.…”

Section: Results Of the Cost-effectiveness Literature Reviewmentioning

confidence: 99%

“…[74][75][76][77][78][79][80][81][82][83][84][85][86] Two studies evaluated the cost-effectiveness of early goaldirected therapy (EGDT) 88,89 and one study evaluated the cost-effectiveness of systemic albumin infusion compared with standard medical care. 87 Two of the 12 rhAPC studies were from the UK.…”

Section: Cost-effectiveness Of Non-intravenous Immunoglobulin Intervementioning

confidence: 99%

“…87 Two of the 12 rhAPC studies were from the UK. 80,82,83 The remainder were from the USA (n = 3), [75][76][77] Canada (n = 2), 74,86 France (n = 2), 84,85 Germany (n = 1), 78 Spain (n = 1) 79 and Sweden (n = 1). 81 Both EGDT analyses were from the USA 88,89 and the one albumin study was from France.…”

Section: Cost-effectiveness Of Non-intravenous Immunoglobulin Intervementioning

confidence: 99%

“…The 16 identified studies [73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89] used a range of alternative methods, assumptions and data sources for several key aspects. From this initial review, three specific issues were subsequently prioritised, which were considered to require additional investigation to assist in extrapolating the short-term results from the studies included in the clinical effectiveness review into lifetime QALY estimates.…”

Section: Follow-up: ≤ 36 Yearsmentioning

confidence: 99%

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An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis.

Soares

Welton²,

Harrison³

et al. 2012

Health Technol Assess

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Kosten der Sepsis

Moerer

Burchardi

2006

Anaesthesist

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In recent years great efforts in clinical sepsis research have led to a better understanding of the underlying pathophysiology and new therapeutic approaches including drugs and supportive care. Despite this success, severe sepsis remains a serious health care problem. Each year approximately 75,000 patients in Germany and approximately 750,000 patients in the USA suffer from severe sepsis. The length of stay and the cost of laborious therapies lead to high intensive care unit (ICU) costs. Sepsis causes a significant national socioeconomic burden if indirect costs due to productivity loss are included and in Germany severe sepsis has been estimated to generate costs between 3.6 and 7.7 billion Euro annually. Thus, this complex and life-threatening disease has been identified as a high cost driver not only for the ICU, but also from the perspectives of hospitals and society. To improve the outcome of severe sepsis, innovative drugs and treatment strategies are urgently needed. Some drugs and strategies already offer promising results and will probably play a major role in the future. Even though their cost-effectiveness is likely, intensive care medicine has to carry a substantial economic burden. This article summarizes studies focusing on the evaluation of direct or indirect costs of sepsis and the cost-effectiveness of new therapies.

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Pin4 Cost-Effectiveness of Drotrecogin Alfa (Activated) in the Treatment of Severe Sepsis in Spain

Cited by 6 publications

References 0 publications

Cost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain

Cost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain

An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis.

Kosten der Sepsis

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