title: Cost-effectiveness of immunoglobulin M-enriched immunoglobulin (Pentaglobin) in the treatment of severe sepsis and septic shock.
abstract: OBJECTIVE
  To measure the cost-effectiveness of a specific polyclonal intravenous immune globulin preparation (Pentaglobin) in adult patients treated for severe sepsis and septic shock.
  
  
  METHODS
  Effectiveness data from a meta-analysis of 9 randomized trials (N=435) were used to populate a decision model to estimate the cost-effectiveness of Pentaglobin and its comparator standard therapy from the hospital perspective in Germany.
  
  
  METHODS
  all-cause morality; secondary outcome: intensive care unit (ICU) length of stay. Benefit was expressed as lives saved (LS). Published cost data were applied to assess differences in ICU treatment costs. Cost-effectiveness was calculated as incremental cost per LS.
  
  
  RESULTS
  Pentaglobin reduced the risk of mortality (P<.001) but had no effect on ICU length of stay. A baseline risk of mortality of 0.4434 (risk ratio=0.5652; absolute risk reduction=0.1928; number-needed-to-treat=5.19) increased ICU treatment costs with Pentaglobin by 2,037 (22,711 vs 24,747) with a cost per LS of 10,565. Sensitivity analyses on baseline mortality risk (95% confidence interval 0.3293-0.5162) and risk ratio (95% confidence interval 0.4306-0.7420) yielded a cost per LS range of 5,715 to 28,443 with a 56.3% probability of cost-effectiveness of 12,000 or less.
  
  
  CONCLUSIONS
  Pentaglobin is a promising adjuvant therapy both clinically and economically for treatment of adults with severe sepsis and septic shock.
authors.affiliation: HealthEcon AG, CH-4001 Basel, Switzerland. aneilson@healthecon.com
authors.forename: Aileen R
authors.initials: AR
authors.lastname: Neilson
authors.forename: Hilmar
authors.initials: H
authors.lastname: Burchardi
authors.forename: Heinz
authors.initials: H
authors.lastname: Schneider
mesh_terms: D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D016527:Drug Costs; D005858:Germany; D006801:Humans; D007070:Immunoglobulin A / Q000191:economics* / Q000627:therapeutic use; D007075:Immunoglobulin M / Q000191:economics* / Q000627:therapeutic use; D007362:Intensive Care Units; D007902:Length of Stay; D018805:Sepsis / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D012772:Shock, Septic / Q000188:drug therapy / Q000191:economics / Q000401:mortality
chemical_list: D007070:Immunoglobulin A; D007075:Immunoglobulin M; C060166:pentaglobulin