title: Management challenge with drotrecogin alfa (activated).
abstract: Clinical trial results for drotrecogin alfa (activated) are discussed in terms of potential effect on morbidity and total cost of care. Interdisciplinary collaboration is crucial for improving care in health systems; teamwork has been shown to improve outcomes in intensive care and reduce costs. The treatment of sepsis is costly and resource intensive. With existing treatments, drugs account for a lower percentage of the total cost than does care in the intensive care unit. Study results indicate that drotrecogin alfa (activated) reduces mortality in severe sepsis without a major morbidity penalty in 28 days. No difference was found in total resource use over 28 days between patients who received the drug and those who received placebo, even though more patients who received drotrecogin alfa (activated) survived and thus required treatment. Estimated costs per life-year saved fall within the cost-effective range. When drotrecogin alfa (activated) becomes available for clinical use, pharmacists must systematically assess this new therapeutic tool in terms of health value.
authors.affiliation: University of Pittsburgh School of Pharmacy, Anticoagulation Clinic Services, Veterans Affairs Health Care System, Pittsburgh, PA, USA.
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Vanscoy
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings; D003422:Critical Care; D016527:Drug Costs; D006801:Humans; D011486:Protein C / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D018805:Sepsis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D026712:Value of Life
chemical_list: D000890:Anti-Infective Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated