title: Cost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis with multiple organ failure.
abstract: OBJECTIVE
  The aim of this study was to estimate the expected cost and clinical benefits associated with the use of drotrecogin alfa (activated) (Xigris; Eli Lilly and Company; Indianapolis, IN) in the French hospital setting.
  
  
  METHODS
  The recombinant human activated PROtein C Worldwide Evaluation in Severe Sepsis (PROWESS) study results (1271 patients with multiple organ failure) were adjusted to 9,948 hospital stays from a database of Parisian area intensive-care units (ICUs)-the CubRea (Intensive Care Database User Group) database. The analysis features a decision tree with a probabilistic sensitivity analysis.
  
  
  RESULTS
  The cost per life year gained (LYG) of drotrecogin treatment for severe sepsis with multiple organ failure (European indication) was estimated to be dollars 11,812. At the hospital level, the drug is expected to induce an additional cost of dollars 7545 per treated patient. The incremental cost-effectiveness ratio ranges from dollars 7873 per LYG for patients receiving three organ supports during ICU stay to dollars 17,704 per LYG for patients receiving less than two organ supports.
  
  
  CONCLUSIONS
  Drotrecogin alfa (activated) is cost-effective in the treatment of severe sepsis with multiple organ failure when added to best standard care. The cost-effectiveness of the drug increases with baseline disease severity, but it remains cost-effective for all patients when used in compliance with the European approved indication.
authors: REES, Paris, France. lionel.riou.reesfrance@wanadoo.fr
authors: Lionel
authors: L
authors: Riou França
authors: Robert
authors: R
authors: Launois
authors: Katell
authors: K
authors: Le Lay
authors: Philippe
authors: P
authors: Aegerter
authors: Myriam
authors: M
authors: Bouhassira
authors: Patrick
authors: P
authors: Meshaka
authors: Bertrand
authors: B
authors: Guidet