PITTSBURGH, Jan. 30 The only FDA-approved drug for the treatment of severe sepsis, drotrecogin alfa (activated) (Xigris), is a cost-effective treatment and has a cost-benefit ratio superior or similar to that of many widely used medical treatments, according to a University of Pittsburgh-led study published in the current issue of the journal Critical Care Medicine (January 2003, Vol. 31, No. 1). In "Cost-effectiveness of Drotrecogin Alfa (Activated) In the Treatment of Severe Sepsis," Derek Angus, M.D., M.P.H., F.C.C.P., associate professor of critical care medicine at the University of Pittsburgh, et al., also report the drug is significantly more cost-effective when used in severe sepsis patients at highest risk of death, and that the drug saves lives without significantly increasing short-term costs or use of medical resources.

Using patient data prospectively collected during the course of the 28-day, multicenter, phase III PROWESS clinical trial, the researchers determined that drotrecogin alfa (activated) costs $48,800 per quality-adjusted life-year (QALY). This figure falls below the widely accepted threshold for cost-effectiveness of $100,000 per QALY. A separate analysis of severe sepsis patients at high risk of death, the group for which the FDA recommended treatment, showed that drotrecogin alfa (activated) cost $27,400 per QALY. Taking into account the estimated lifespan of a patient as well as health status during his/her remaining years of life, the quality-adjusted life-year is widely regarded by health care economists to be the most comprehensive tool used to calculate the cost-effectiveness of medical treatments.

The study also concluded that drotrecogin alfa (activated) is as cost-effective, if not more cost effective, than many commonly used life-saving treatments, including: statins for secondary prevention of coronary artery disease/stroke ($48,000 per QALY); neonatal intensive care ($49,000 per QALY); tissue plasminogen activ
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Contact: Jocelyn Uhl
412-647-3555
University of Pittsburgh Medical Center
30-Jan-2003

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