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Treatment of the critically ill patient with protein C: Is it worth the cost?

Nilsson, Gunnar LU ; Höjgård, Sören LU and Berntorp, Erik LU (2010) In Thrombosis Research 125(6). p.494-500
Abstract
INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were... (More)
INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were calculated. RESULTS: Total costs per life saved in 2007 prices (upper limit of 95% CI) were calculated at euro 50,200 (recombinant activated protein C, drotrecogin alfa (activated), Xigris((R))) and euro 46,000 (zymogen protein C, Ceprotin), which may be compared to the value of a statistical life (euro 937,000). CONCLUSIONS: Our theoretical model of converting a low protein C group to a higher protein C group by treating with activated protein C or the protein zymogen showed no major difference between the treatments in terms of costs, and that costs are lower than the value of a statistical life. Although our study has several caveats the results support the PROWESS study, in that patients with a very severe disease, having low protein C levels, may benefit from protein C treatment in a cost effective way. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thrombosis Research
volume
125
issue
6
pages
494 - 500
publisher
Elsevier Ltd
external identifiers
  • wos:000278026400004
  • pmid:19854472
  • scopus:77952553093
ISSN
1879-2472
DOI
10.1016/j.thromres.2009.09.008
language
English
LU publication?
yes
id
be88347f-332f-4a9c-b15c-d46e5cbb4a2b (old id 1500009)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19854472?dopt=Abstract
date added to LUP
2009-11-03 09:53:35
date last changed
2018-05-29 11:28:23
@article{be88347f-332f-4a9c-b15c-d46e5cbb4a2b,
  abstract     = {INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were calculated. RESULTS: Total costs per life saved in 2007 prices (upper limit of 95% CI) were calculated at euro 50,200 (recombinant activated protein C, drotrecogin alfa (activated), Xigris((R))) and euro 46,000 (zymogen protein C, Ceprotin), which may be compared to the value of a statistical life (euro 937,000). CONCLUSIONS: Our theoretical model of converting a low protein C group to a higher protein C group by treating with activated protein C or the protein zymogen showed no major difference between the treatments in terms of costs, and that costs are lower than the value of a statistical life. Although our study has several caveats the results support the PROWESS study, in that patients with a very severe disease, having low protein C levels, may benefit from protein C treatment in a cost effective way.},
  author       = {Nilsson, Gunnar and Höjgård, Sören and Berntorp, Erik},
  issn         = {1879-2472},
  language     = {eng},
  number       = {6},
  pages        = {494--500},
  publisher    = {Elsevier Ltd},
  series       = {Thrombosis Research},
  title        = {Treatment of the critically ill patient with protein C: Is it worth the cost?},
  url          = {http://dx.doi.org/10.1016/j.thromres.2009.09.008},
  volume       = {125},
  year         = {2010},
}