Activated protein C: cost matters!

Excerpt

Activated protein C (APC) is an effective treatment in multiorgan failure (MOF) due to severe sepsis. Recommended duration of treatment of APC is 96 hours infusion. The cost of APC infusion for 96 hours in a 60 kg person is an average INR 490,000 in India (€7,000) (€1 ~ INR 70 in November 2009, average value) whereas the average cost of 10 days of ICU treatment for a patient with sepsis with MOF, all inclusive, is approximately INR 140,000 in our hospital (€2,000). It is unclear whether stopping APC before 96 hours, in patients in whom MOF resolves before 96 hours, ultimately affects the final outcome in terms of survival. This is more relevant in developing countries like India where the cost of 96 hours of infusion of APC is beyond the reach of the majority of patients eligible for it. We retrospectively analysed the cost savings achieved by early stoppage of APC ensuring MOF reversal, before completion of the recommended 96 hours infusion. …