Drotrecogin alfa (activated) in severe sepsis: a systematic review and new cost-effectiveness analysis
2007

Cost-Effectiveness of Drotrecogin Alfa in Severe Sepsis

Sample size: 3183 publication 10 minutes Evidence: moderate

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)

10.1186/1471-2253-7-5

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