Long-term costs and cost-effectiveness of adjunctive corticosteroids for patients with septic shock in New Zealand.
Aust Crit Care
; 35(3): 241-250, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-34325975
ABSTRACT
OBJECTIVE:
The aim of the study was to determine whether adjunctive hydrocortisone reduced healthcare expenditure and was cost-effective compared with placebo in New Zealand patients in the Adjunctive Glucocorticoid Therapy in Patients with Septic Shock (ADRENAL) trial.DESIGN:
This is a health economic analysis using data linkage to New Zealand Ministry of Health databases to determine resource use, costs, and cost-effectiveness for a 24-month period.SETTING:
The study was conducted in New Zealand. PARTICIPANTS AND INTERVENTION Patients with septic shock were randomised to receive a 7-day continuous infusion of 200 mg of hydrocortisone or placebo in the ADRENAL trial. MAIN OUTCOMEMEASURES:
Healthcare expenditure was associated with all hospital admissions, emergency department presentations, outpatient visits, and pharmacy expenditure. Effectiveness outcomes included mortality at 6 months and 24 months and quality of life at 6 months. Cost-effectiveness outcomes were assessed with reference to quality-adjusted life years gained at 6 months and life years gained at 24 months.RESULTS:
Of 3800 patients in the ADRENAL trial, 419 (11.0%) were eligible, and 405 (96.7% of those eligible) were included. The mean total costs per patient over 24 months were $143,627 ± 100,890 and $143,772 ± 97,117 for the hydrocortisone and placebo groups, respectively (p = 0.99). Intensive care unit costs for the index admission were $50,492 and $62,288 per patient for the hydrocortisone and placebo groups, respectively (p = 0.09). The mean number of quality-adjusted life years gained at 6 months and mean number of life years gained at 24 months was not significantly different by treatment group, and the probability of hydrocortisone being cost-effective was 55% at 24 months.CONCLUSIONS:
In New Zealand, adjunctive hydrocortisone did not reduce total healthcare expenditure or improve outcomes compared with placebo in patients with septic shock.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Séptico
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Limite:
Humans
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Aust Crit Care
Assunto da revista:
ENFERMAGEM
/
TERAPIA INTENSIVA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália