title: Drotrecogin alfa (activated; Xigris): an effective and cost-efficient treatment for severe sepsis.
abstract: Severe sepsis is a common health problem with consequences for both patients and the healthcare system. Over the past 20 years, multiple immunomodulatory agents have been investigated in an unsuccessful attempt to decrease the morbidity and mortality of severe sepsis. Drotrecogin alfa (activated; Xigris) may represent a breakthrough in the treatment of sepsis. It has been demonstrated to have beneficial effects in decreasing biological markers of the severity of sepsis in preclinical and Phase II studies. A single, large Phase III trial has demonstrated the efficacy of drotrecogin alfa (activated) in a sample of patients with severe sepsis. This sample appears to be comparable with the general population of patients with severe sepsis. Three separate economic analyses have shown drotrecogin alfa (activated) to have a cost-utility ratio similar to other therapies that are currently funded, when used for the treatment of the most severely ill group of patients. This review provides an opinion that drotrecogin alfa (activated) is a cost-efficient therapy that should be considered as part of a standard of care in healthcare systems that can provide a modern critical care service.
authors.affiliation: Department of Critical Care, Internal Medicine and Community Health, Medicine Faculty of Medicine, University of Calgary, Rm EG23G, Foothills Medical Center, 1403-29th Street NW, Calgary AB, T2N 2T9, Canada. cdoig@ucalgary.ca
authors.forename: Christopher James
authors.initials: CJ
authors.lastname: Doig
authors.forename: David A
authors.initials: DA
authors.lastname: Zygun
authors.forename: Anthony
authors.initials: A
authors.lastname: Delaney
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Manns