Cost-effectiveness of Activated Protein C in Severe Sepsis
Author Information
Author(s): Dhainaut Jean-François, Payet Stéphanie, Vallet Benoit, França Lionel Riou, Annane Djillali, Bollaert Pierre-Edouard, Tulzo Yves Le, Runge Isabelle, Malledant Yannick, Guidet Bertrand, Le Lay Katell, Launois Robert
Primary Institution: Cochin Port-Royal University Hospital, AP-HP, René Descartes University, Paris 5, Paris, France
Hypothesis
Is recombinant human activated protein C (rhAPC) cost-effective in real-life clinical practice for patients with severe sepsis and multiple organ failure?
Conclusion
The study found that rhAPC is likely to be cost-effective in real-life clinical practice for severe sepsis patients if the willingness to pay is €50,000 per life-year gained.
Supporting Evidence
- 28-day mortality was reduced from 37.4% to 34.1% post-license.
- Hospital costs increased from €36,717 to €47,870 post-license.
- 74.5% probability that rhAPC is cost-effective at €50,000 per life-year gained.
Takeaway
This study looked at whether a new treatment for very sick patients with infections is worth the money. It found that it can be a good deal if we are willing to spend a certain amount to help them live longer.
Methodology
A prospective observational study was conducted with adult patients before and after the licensure of rhAPC, using propensity score matching to control for bias.
Potential Biases
Selection bias may exist due to non-randomized design, despite efforts to control it using propensity score matching.
Limitations
The study was not randomized, which may introduce selection bias, and it was underpowered for effectiveness issues.
Participant Demographics
Mean age was 62.4 years, with a mean SAPS II score of 56.7 and an average of 3.20 organ failures.
Statistical Information
P-Value
0.34
Confidence Interval
95% CI for cost differences
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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