This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ernst, F. R. Articles by Qualy, R. L. Search for Related Content PubMed PubMed Citation Articles by Ernst, F. R. Articles by Qualy, R. L. Social Bookmarking                   What's this?

Simplified Pharmacoeconomics of Critical Care and Severe Sepsis

Eli Lilly and Company, Outcomes Research-U.S. Medical Division, Indianapolis, IN, frank_ernst{at}premierinc.com

Howard Levy, MD, PhD, MMM

Eli Lilly and Company, Outcomes Research-U.S. Medical Division, Indianapolis, IN

Rebecca L. Qualy, MS

Eli Lilly and Company, Outcomes Research-U.S. Medical Division, Indianapolis, IN

Understanding pharmacoeconomic evaluation can empower clinicians to be stronger decision makers. However, cost-effectiveness analyses (CEAs) in critical care are sometimes not easy to understand and often not placed in context with other interventions. The purpose of this article is to clarify and simplify the CEA process using examples from critical care and severe sepsis. First discussed is cost-effectiveness as a framework for clinical decision making and how it compares to other types of economic evaluations. Then important considerations when conducting or reviewing CEAs are explored, such as perspective, discounting, sensitivity analysis, and grading of CEAs, as well as shortcomings and resistance to using CEAs. Next, applications of CEA in critical care and severe sepsis are reviewed. Included is the Food and Drug Administration-approved drug for severe sepsis, drotrecogin alfa (activated), as an example of a recently new critical care intervention that resulted in significant interest in understanding cost-effectiveness. Finally, CEAs of other medical and nonmedical interventions are placed in context with CEAs from critical care. Understanding pharmacoeconomic evaluation can empower clinicians to be stronger decision makers. CEAs provide decision makers a quantitative measure of the value of therapeutic options that can guide clinicians toward balancing the cost burdens of therapy with their profound effects and choosing between options that compete for funding.

Key Words: pharmacoeconomics • cost-effectiveness • critical care • severe sepsis • drotrecogin alfa (activated)

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?