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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
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thrombosis Research
volume
125
issue
6
pages
494 - 500
publisher
Elsevier
external identifiers
  • wos:000278026400004
  • pmid:19854472
  • scopus:77952553093
ISSN
1879-2472
DOI
10.1016/j.thromres.2009.09.008
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Anaesthesiology and Intensive Care (Mö) (013241110), Division of Health Economics and Forensic Medicine (Closed 2012) (013040050), Clinical Coagulation Research Unit (013242510)
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
2016-04-01 11:03:12
date last changed
2022-01-26 04:59:35
@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}},
  series       = {{Thrombosis Research}},
  title        = {{Treatment of the critically ill patient with protein C: Is it worth the cost?}},
  url          = {{https://lup.lub.lu.se/search/files/2342016/1710475.pdf}},
  doi          = {{10.1016/j.thromres.2009.09.008}},
  volume       = {{125}},
  year         = {{2010}},
}