title: Cost effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom.
abstract: Drotrecogin alfa (activated) is licensed in Europe for the treatment of severe sepsis in patients with multiple organ failure. We constructed a model to assess the cost effectiveness of drotrecogin alfa (activated) from the perspective of the UK National Health Service when used in adult intensive care units. Patient outcomes from a 28-day international clinical trial (PROWESS) and a subsequent follow-up study (EVBI) were supplemented with UK data. Cost effectiveness was assessed as incremental cost per life year and per quality adjusted life year saved compared to placebo alongside best usual care. Applying the 28-day mortality outcomes of the PROWESS study, the model produced a cost per life year saved of 4608 UK pounds and cost per quality adjusted life year saved of 6679 UK pounds. Equivalent results using actual hospital outcomes were 7625 UK pounds per life year and 11,051 UK pounds per quality adjusted life year. Drotrecogin alfa (activated) appears cost effective in treating severe sepsis in UK intensive care units.
authors.affiliation: MEDTAP International, 20 Bloomsbury Square, London WC1A 2NS, UK. davies@medtap.com
authors.forename: A
authors.initials: A
authors.lastname: Davies
authors.forename: S
authors.initials: S
authors.lastname: Ridley
authors.forename: J
authors.initials: J
authors.lastname: Hutton
authors.forename: C
authors.initials: C
authors.lastname: Chinn
authors.forename: B
authors.initials: B
authors.lastname: Barber
authors.forename: D C
authors.initials: DC
authors.lastname: Angus
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000191:economics / Q000401:mortality; D011486:Protein C / Q000191:economics / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D013222:State Medicine / Q000191:economics; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated