Evaluation of the cost-effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom
Evaluation of the cost-effectiveness of drotrecogin alfa (activated) for the treatment of severe sepsis in the United Kingdom
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DOI：
10.1017/s0266462306050884
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发表时间：
2006-12-01
影响因子：
3.2
通讯作者：
Cuthbertson, BH
中科院分区：
文献类型：
--
作者：
Green, C;Dinnes, J;Cuthbertson, BH
目的：本研究的目的是评估的成本效益的drotaldine阿尔法（激活）相比，最好的支持性治疗在英国队列的成人重症监护患者严重sepsis.Methods：一个系统的审查证据的临床和成本效益的drotaldine阿尔法（激活）进行了，并制定了一个决策分析模型，以估计在英国的治疗的成本效益。重组人活化蛋白C全球严重脓毒症评估（PROWESS）研究的试验数据已与其他数据（包括英国严重脓毒症数据）进行综合，以估计随着时间的推移治疗的成本和后果。结果：对于严重脓毒症和多器官功能障碍患者，每生命年成本和每质量调整生命年（QALY）成本的估计值分别为14，931和8，228磅，分别。对于单独的严重脓毒症患者，每生命年的成本和每QALY的成本分别为5，495磅和9，161磅。而阿尔法的治疗费用（激活）显示为高（每个病人大约5,000磅），对供应商预算的潜在影响是相当大的，（活化的）是临床有效的，代表了资源的成本有效利用，并且是治疗需要重症监护的患者中的严重脓毒症的显著进步。
Objectives: The aim of this study was to assess the cost-effectiveness of drotrecogin alfa (activated) compared with best supportive care in a UK cohort of adult intensive-care patients with severe sepsis.Methods: A systematic review of evidence on the clinical- and cost-effectiveness of drotrecogin alfa (activated) was undertaken, and a decision-analytic model was developed to estimate the cost-effectiveness of treatment in the United Kingdom. Trial data from the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study have been synthesized with other data, including UK data on severe sepsis, to estimate the costs and consequences of treatment over time.Results: For patients with severe sepsis and multiple organ dysfunction, the estimates of cost per life year and cost per quality-adjusted life year (QALY) are 14,931 and 8,228 pound, respectively. For patients with severe sepsis alone, the cost per life-year and cost per QALY are 5,495 pound and 9,161 pound, respectivelyConclusions: Whereas the therapeutic cost for drotrecogin alfa (activated) appears high (at around 5,000 pound per patient) and the potential impact on the provider budget is considerable, drotrecogin alfa (activated) is clinically effective, represents a cost-effective use of resources, and is a significant advance in the treatment of severe sepsis in patients requiring intensive care.