Cost-effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in Germany

Neilson, Aileen; Burchardi, H.; Chinn, C.; Clouth, Johannes; Schneider, H; Angus, Derek C.

doi:10.1016/j.jcrc.2003.10.005

Cited by 50 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a meta-analysis of studies with intravenous immunoglobulin for severe sepsis and septic shock, a decision model was developed to estimate the cost-effectiveness of the intervention (13); in another meta-analysis of nine randomized clinical trials (RCTs) with various dosing regimens of M-enriched immunoglobulin (14), the cost-effectiveness analysis was based on mean daily costs derived from a previous study of severe sepsis. After the publication of the PROWESS study, several studies were conducted on the cost-effectiveness of drotrecogin-alpha in severe sepsis; all of them supplemented the clinical data from the original study with local financial data from the United States (15), Canada (16), Germany (17), and the United Kingdom (18,19). The present study avoids such systemic bias.…”

Section: Discussionmentioning

confidence: 99%

Clarithromycin Leads to Long-Term Survival and Cost Benefit in Ventilator-Associated Pneumonia and Sepsis

Τσαγανός

Rosario

Pratikaki

et al. 2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

cIncreasing numbers of admissions for sepsis impose a heavy burden on health care systems worldwide, while novel therapies have proven both expensive and ineffective. We explored the long-term mortality and hospitalization costs after adjunctive therapy with intravenous clarithromycin in ventilator-associated pneumonia (VAP). Two hundred patients with sepsis and VAP were enrolled in a published randomized clinical trial; 100 were allocated to blind treatment with a placebo and another 100 to clarithromycin at 1 g daily for three consecutive days. Long-term mortality was recorded. The hospitalization cost was calculated by direct quantitation of imaging tests, medical interventions, laboratory tests, nonantibiotic drugs and antibiotics, intravenous fluids, and parenteral and enteral nutrition. Quantities were priced by the respective prices defined by the Greek government in 2002. The primary endpoint was 90-day mortality; cumulative hospitalization cost was the secondary endpoint. All-cause mortality rates on day 90 were 60% in the placebo arm and 43% in the clarithromycin arm (P ‫؍‬ 0.023); 141 patients were alive on day 28, and mortality rates between days 29 and 90 were 44.4% and 17.4%, respectively (P ‫؍‬ 0.001). The mean cumulative costs on day 25 in the placebo group and in the clarithromycin group were €14,701.10 and €13,100.50 per patient staying alive, respectively (P ‫؍‬ 0.048). Respective values on day 45 were €26,249.50 and €19,303.10 per patient staying alive (P ‫؍‬ 0.011); this was associated with the savings from drugs other than antimicrobials. It is concluded that intravenous clarithromycin for three consecutive days as an adjunctive treatment in VAP and sepsis offers long-term survival benefit along with a considerable reduction in the hospitalization cost. (This study has been registered at ClinicalTrials.gov under registration no. NCT00297674.)

show abstract

Section: Discussionmentioning

confidence: 99%

Clarithromycin Leads to Long-Term Survival and Cost Benefit in Ventilator-Associated Pneumonia and Sepsis

Τσαγανός

Rosario

Pratikaki

et al. 2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Economic evaluations in several countries including the United Kingdom, France, Germany, Sweden, the United States, and Canada [30][31][32][33][34][35][36][37] show that APC is cost effective, on a short-term basis, in severe sepsis. Further, when APC is administered, according to the PROWESS criteria, to individuals with more severe disease (APACHE II score ≥25), it has a lifetime cost-effectiveness profile that compares well to that of many widely accepted therapies [33,35].…”

Section: Discussionmentioning

confidence: 99%

Treatment of the critically ill patient with protein C: Is it worth the cost?

Nilsson

Höjgård

Berntorp

2010

Thrombosis Research

View full text Add to dashboard Cite

“…There are no differences in PROWESS patients' Therapeutic Intervention System Scores (TISS; an indirect measure of intensity of resource use) or length of stay when these are compared for survivors and non-survivors in the two arms [7]. However, there are significant differences in length of stay of survivors in the USA, Europe and elsewhere [9]. As PROWESS did not include UK patients, we estimated length of stay in our analyses using data from the Case Mix Programme Database, a large UK database of intensive care patients.…”

Section: Discussionmentioning

confidence: 99%

“…Previous cost effectiveness studies of drotrecogin alfa (activated) have been undertaken in the USA, Canada and Germany using methods appropriate to those countries [7][8][9] but no UK analysis of cost effectiveness has yet been undertaken. As information on cost effectiveness is required by health service decision makers, we performed an economic evaluation of drotrecogin alfa (activated) for the treatment of severe sepsis with multiple organ failure in ICUs in the UK.…”

mentioning

confidence: 99%

Cost effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom*

Davies¹,

Ridley

Hutton³

et al. 2005

Anaesthesia

View full text Add to dashboard Cite

SummaryDrotrecogin 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 and cost per quality adjusted life year saved of £6679. Equivalent results using actual hospital outcomes were £7625 per life year and £11 051 per quality adjusted life year. Drotrecogin alfa (activated) appears cost effective in treating severe sepsis in UK intensive care units.

show abstract

Cost-effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in Germany

Cited by 50 publications

References 23 publications

Clarithromycin Leads to Long-Term Survival and Cost Benefit in Ventilator-Associated Pneumonia and Sepsis

Clarithromycin Leads to Long-Term Survival and Cost Benefit in Ventilator-Associated Pneumonia and Sepsis

Treatment of the critically ill patient with protein C: Is it worth the cost?

Cost effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom*

Contact Info

Product

Resources

About