Inbinding site of AT with GAGs on cell surface.P116 Expense effectiveness analysis of drotrecogin alfa

Inbinding site of AT with GAGs on cell surface.P116 Expense effectiveness analysis of drotrecogin alfa (activated) as a remedy for extreme sepsis in hospitalised patientsR Launois*, L Riou Franca*, B Guidet, P Aegerter, X Huet? P Meshaka? P Pinton?*REES France, R eau d’Evaluation en Economie de la Sant? 28 rue d’Assas, 75006 Paris, France; H ital Saint Antoine, 184 rue du fb Saint Antoine, 75012 Paris, France; Biostatistique et Informatique m icale, H ital Ambroise Par? 9 avenue Charles de Gaulle, 92100 Boulogne, France; �Laboratoire Lilly France, 203 bureau de la colline, 92213 St Cloud, France Introduction: Drotrecogin alfa (activated) drastically reduced severe sepsis (SevSep) mortality at 28 days [1]. Based on the French budget atmosphere, it is actually mandatory to evaluate its expense effectiveness ratio on a pragmatic basis. Approaches: All SevSep patients in the Cub-R database (1997?999 period) defined in line with PROWESS [1] and with a hospital length of stay (LOS) 24 hours (n = ten,459) have been included. The baseline patients’ traits are similar to these in the PROWESS criteria study: age (61 years vs 60 years), < 60 years (42 vs 44 ), and number of organ failure (2.1 vs 2.4). Key patient data recorded: age, gender, type of admission (medical or surgical), admission mode (direct or transfer), number (1, 2, 3), duration and type of support (respiratory, renal, circulatory) and SAPS II. Stratification according to these criteria and loading of the observed frequencies into a decision-tree for conditional probabilities. Relative risk of death with drotrecogin alfa (activated) estimated according to the observed classification into 11 n GHM [2] groups (28 days YKL-05-099 site survival represented by the parametric function of Weibull). SevSep impact on long-term mortality estimatedAvailable online http://ccforum.com/supplements/6/Sby the McCabe score with three hypotheses for life expectancy (LE): unique LE of 5 years, McCabe > 0 (two years of survival), McCabe = 0 (four years LE reduction or half LE reduction versus whole population). Charges estimated by subgroups and by a linear equation (nursing workload, LOS, SAPS II, living or dead status). Calculation of a differential cost effectiveness ratio (drotrecogin alpha (activated) price: 7836.95 for 4 days therapy and a mean patient’s weight of 70 kg) and analysis of Monte Carlo’s sort. Final results: The anticipated price inside the model of a SevSep patient treated by common care is 26,983.three FF96 vs 26,373.six FF96 observed from Cub-R . The expected price predicted inside the model of a SevSep patient treated by drotrecogin alfa (activated) is 34,605.90 FF96. The survivors LE in line with the above hypotheses are five.0, 10.6, and six.9 years. Corresponding effective-ness variations PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20724452 in favor of drotrecogin alfa (activated) are 0.33, 0.63, and 0.41 years. The cost per added year of life saved amounts of 18,446.three FF96 including all degrees of severity and co-morbidity. The sensitivity evaluation model shows that with an expected threshold of 53,357.1 FF96, 96.three on the bootstrap samples are cost-effective. Conclusion: The predicted price effectiveness ratio of drotrecogin alfa (activated) in adult SevSep sufferers is much reduce than the international range thought of as acceptable (53,357.10 ). Drotrecogin alfa (activated) is cost-effective when including individuals with all degrees of co morbidity. The outcomes of those measurements, demographic information, mortality and incidence of acute respiratory distress syndrome (ARDS), MO.