Cost-Effectiveness of Drotrecogin Alfa in Severe Sepsis
Author Information
Author(s): Costa Vania, Brophy James M
Primary Institution: McGill University Health Centre
Hypothesis
Is drotrecogin alfa (activated) effective and cost-effective for treating severe sepsis?
Conclusion
The evidence supporting the clinical and economic attractiveness of drotrecogin alfa is not conclusive and further research appears to be indicated.
Supporting Evidence
- Two randomized clinical trials were identified.
- No statistically significant 28-day mortality benefit was found for drotrecogin alfa compared to placebo.
- The cost-effectiveness of drotrecogin alfa is uncertain when applied to all patients with severe sepsis.
Takeaway
Drotrecogin alfa is a treatment for severe sepsis, but studies show it may not help patients live longer or be worth the cost.
Methodology
A systematic literature review and economic analysis using Monte Carlo simulations.
Potential Biases
Potential for bias due to the reliance on a limited number of studies and subgroup analyses.
Limitations
The analysis is based on only two RCTs with evidence of statistical heterogeneity and uncertain estimates of clinical efficacy.
Participant Demographics
Adults with severe sepsis, mean age around 60 years, with varying APACHE II scores.
Statistical Information
P-Value
0.001
Confidence Interval
95% CI: 0.69, 1.26
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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