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 21 February 2018

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News

Activated protein C for the treatment of severe sepsis can be cost effective

Activated protein C is relatively cost effective when targeted to patients with severe sepsis, especially those with a greater severity of illness and a reasonable life expectancy, according to a study in the New England Medical Journal.

News image

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A previous study has shown that recombinant human activated protein C reduces mortality among patients with severe sepsis.

Additionally, post hoc analyses by the Food and Drug Administration (FDA) suggested that the reduction in mortality is restricted to patients with a greater severity of illness.

In this study, researchers from Canada estimated the cost effectiveness of activated protein C, compared with conventional care for patients with severe sepsis.

The team used data from the previous study, plus the analyses by the FDA.

Activated protein C more effective in severe sepsis.
New England Journal of Medicine
An economic investigation was performed, including analyses of patient subgroups defined according to age and severity of illness.

Furthermore, the probabilities of transition between clinical states and the estimates of resource use were derived from a population-based cohort of patients with severe sepsis.

The research team found that the cost per life-year gained by treating all patients with activated protein C was $27,936.

They also found that it was more cost effective to treat patients with an Acute Physiology and Chronic Health Evaluation (APACHE II) score of 25 or more ($24,484 per life-year gained) than those with a lower APACHE II score ($35,632 per life-year gained).

However, the cost effectiveness of treating patients with an APACHE II score of 24 or less increased to $575,054 per life-year gained when the FDA's estimates of effectiveness were considered.

For patients with an APACHE II score of 25 or more, the cost per life-year gained increased with age ($16,309 for patients less than 40 years of age; $28,100 for those 80 years of age or older).

Dr Braden Manns' team concluded, "Activated protein C is relatively cost effective when targeted to patients with severe sepsis, greater severity of illness (an APACHE II score of 25 or more), and a reasonable life expectancy if they survive the episode of sepsis".

"However, further research is needed to determine the cost effectiveness of activated protein C for patients with sepsis and less severe illness".

NEJM 2002; 347 (13): 993
27 September 2002

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