Pharmacoeconomic implications of new therapies in sepsis.

摘要: Severe sepsis is a major healthcare problem, characterised by high incidence, mortality and cost. New breakthroughs in treatment are quite diverse, including: (i) more effective regimens for generic, inexpensive broad anti-inflammatory agents (corticosteroids); (ii) recombinant protein (drotrecogin-alfa [activated]); (iii) protocol-based approach (early goal-directed therapy). Economic analyses of new should adopt the societal perspective, which requires prolonging time horizon beyond that currently typically studied trials, so patient-centred outcomes can be fully captured. Sepsis affects very diverse group patients, if findings to generalisable, careful attention must paid study entry criteria differences effects costs across different patient subgroups. Existing care patterns also with consequence incremental on could vary widely practice pattern, again affecting generalisability. Furthermore, many patients receive multiple other therapies, together therapies under may have varied unintended, potentially costly or dangerous adverse effects, large influence cost-effectiveness estimates. Finally, there number yet hidden sepsis, such as long-term managing who develop introducing interventions into clinical practice. Such addressed economic analyses. The search anti-sepsis strategies remains vigourous exciting. We recommend wider incorporation potential appropriate caveats discussed above. Clinical demand use balanced against consequences their use.