Economic Aspects of Severe Sepsis: A Review of Intensive Care Unit Costs, Cost of Illness and Cost Effectiveness of Therapy

Author
InfoHilmar Burchardi (Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Hospital Gottingen, Gottingen, Germany)Heinz Schneider (HealthEcon AG, Basel, Switzerland)

Abstract
Severe sepsis remains both an important clinical challenge and an economic burden in intensive care. An estimated 750 Sepsis patients are generally treated in intensive care units (ICUs) where close supervision and intensive care treatment by a competent team with adequate equipment can be provided. Staffing costs represent from 40% to >60% of the total ICU budget. Because of the high proportion of fixed costs in ICU treatment, the total cost of ICU care is mainly dependent on the length of ICU stay (ICU-LOS). The average total cost per ICU day is estimated at approximately Patients with infections and severe sepsis require a prolonged ICU-LOS, resulting in higher costs of treatment compared with other ICU patients. US cost-of-illness studies focusing on direct costs per sepsis patient have yielded estimates of Because of increasing healthcare cost pressures worldwide, economic issues have become important for the introduction of new innovations.
This is evident when introducing new biotechnology products, such as drotrecogin-alpha (activated protein C), into specific therapy for severe sepsis. Data so far suggest that when drotrecogin-alpha treatment is targeted to those patients most likely to achieve the greatest benefit, the drug is cost effective by the standards of other well accepted life-saving interventions.