Is Drotrecogin alfa (activated) for adults with severe sepsis, cost-effective in routine clinical practice?

Table 5 Lifetime costs in pounds sterling, quality-adjusted life years, and incremental net benefits in pounds sterling after Genetic Matching

	DrotAA, mean (SD)	Control, mean (SD)	Incremental, mean (95% CI)
Overall: two to five organ systems failing
Lifetime costs	36,048 (35,522)	18,432 (26,708)	17,616 (15,959 to 19,273)
Lifetime QALYs	5.70 (6.57)	5.11 (6.61)	0.58 (0.24 to 0.93)
INB^a	77,896 (131,138)	83,830 (129,324)	-5,934 (-12,735 to 868)
Two organ systems failing
Lifetime costs	31,191 (21,959)	16,488 (18,399)	14,703 (12,763 to 16,644)
Lifetime QALYs	5.87 (6.54)	6.83 (6.75)	-0.97 (-1.62 to -0.32)
INB^a	86,117 (130,821)	120,148 (134,047)	-34,031 (-47,028 to -21,034)
Three to five organ systems failing
Lifetime costs	38,520 (43,205)	18,572 (27,266)	19,948 (17,610 to 22,286)
Lifetime QALYs	5.63 (6.59)	4.35 (6.33)	1.28 (0.86 to 1.70)
INB^a	74,038 (132,559)	68,348 (122,496)	5,690 (-2,543 to 13,924)

Overall (two to five organ systems failing): total number = 2,726, Drotrecogin alfa (activated) (DrotAA) = 1,076, control = 1,650; two organ systems failing: total number = 828, DrotAA = 198, control = 630; three to five organ systems failing: total number = 1,898, DrotAA = 878, control = 1,020. ^aIncremental net benefits (INBs) are calculated by following method guidance [36] and multiplying the mean quality-adjusted life year (QALY) gain (or loss) by £20,000 and subtracting from this the incremental cost. CI, confidence interval; SD, standard deviation.

ISSN: 1364-8535