Cost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis
Cost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis
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DOI：
10.1097/00003246-200301000-00001
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发表时间：
2003-01-01
影响因子：
8.8
通讯作者：
van Hout, B
中科院分区：
文献类型：
--
作者：
Angus, DC;Linde-Zwirble, WT;van Hout, B
目标。目的：评估最近被证明可降低严重败血症死亡率的屈曲霉素阿尔法(主动)疗法的成本-效果。对有效性和资源使用的估计是基于作为多中心国际试验的一部分预期收集的数据。对医院费用的估计是基于在美国接受治疗的患者的一部分(占所有登记患者的33%)。寿命预测是根据已公布的来源建立的，并在敏感性分析中进行了测试。分析是从美国社会的角度进行的，仅限于医疗成本，并使用3%的年贴现率。11个国家的164家医疗机构。患者。干预：符合条件的患者被随机分成两组，分别接受96小时静脉滴注24杯/公斤/小时(n=850)或安慰剂(n=840)。测量和主要结果：基本情况：每天增加的短期(第1-28天)医疗费用-28名幸存者；卫生与医学成本效益小组参考案例：每一质量调整的生命年增加的终生医疗费用。在最初的28天(短期基础病例)中，屈曲可金阿尔法(激活)使每个接受治疗的患者的护理成本增加了9,800美元，生存时间增加了0.061人。因此，Drotrecogin Alfa(激活)每挽救一条生命需要花费160,000美元(概率为84.7%
Objective. To assess the cost-effectiveness of drotrecogin alfa (activated) therapy, which was recently shown to reduce mortality in severe sepsis.Design. Estimates of effectiveness and resource use were based on data collected prospectively as part of a multicenter international trial. Estimates of hospital costs were based on a subset of the patients treated in the United States (33% of all enrolled patients). Lifetime projections were modeled from published sources and tested in sensitivity analyses. Analyses were conducted from the United States societal perspective, limited to healthcare costs, and using a 3% annual discount rate.Setting. A total of 164 medical institutions in 11 countries.Patients. Adults greater than or equal to18 yrs of age with severe sepsis.Interventions: Eligible patients were randomly assigned to receive a 96-hr intravenous infusion of drotrecogin alfa (activated) at 24 mug/kg/hr (n = 850) or placebo (n = 840).Measurements and Main Results: Base Case: incremental short-term (days 1-28) healthcare costs per day-28 survivor; Panel on Cost-Effectiveness in Health and Medicine Reference Case: incremental lifetime healthcare costs per quality-adjusted life-year. Over the first 28 days (short-term Base Case), drotrecogin alfa (activated) increased the costs of care by $9,800 and survival by 0.061 lives saved per treated patient. Thus, drotrecogin alfa (activated) cost $160,000 per life saved (with 84.7% probability that ratio is