Recombinant human activated protein C is relatively cost-effective for treating severe sepsis patients with an Acute Physiology and Chronic Health Evaluation (APACHE II) score of 25 or more, according to a study published in the Sept. 26 issue of the New England Journal of Medicine. The economic implications of widespread use of the drug are important, given the high cost of activated protein C ($6,800 per therapeutic course) and the high incidence of severe sepsis.
The Food and Drug Administration (FDA) had conducted a post hoc reanalysis of data from the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study. Researchers, who estimated the cost-effectiveness of activated protein C as compared with conventional care for patients with severe sepsis, used data on the effectiveness of activated protein C from the PROWESS study and analyses by the FDA. The researchers performed an economic analysis involving all patients, as well as analyses of subgroups defined according to age and severity of illness.
Results showed that the cost per life-year gained by treating all patients with activated protein C was $27,936. It was more cost-effective to treat patients with an 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). 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). The researchers say further research is needed to determine the cost-effectiveness of activated protein C for patients with sepsis and less severe illness.