OBJECTIVES: Despite the development of new antibiotics, sepsis continues to lead to death in at least one in four patients. It is also a major cause of child mortality, accounting for 26% of all neonatal deaths worldwide. According to German guidelines, one of the strategies in sepsis management is the adjunctive treatment with IgM-enriched immunoglobulins. This research aims to investigate the cost per life saved of treating sepsis patients with IgM-enriched immunoglobulins.

METHODS: A cost per life saved model was developed for Germany. Effectiveness data was obtained from a systematic literature review including only sepsis studies published after 2005 with mortality as a main outcome. The costs were calculated using the list price of IgM-enriched immunoglobulin in Germany and the DRG (Diagnosis Related Groups) revenue for ICU.

RESULTS: Based on five studies (N=502) of adult sepsis patients, treatment with IgM-enriched immunoglobulins reduced the absolute mortality rate by 25.5%, rendering a NNT of 3.93. The average treatment costs in Germany are 4106€ leading to 16114€ costs per life saved. Four studies in pediatric sepsis patients (N=335) showed an absolute mortality reduction of 32%. For a 2-year-old patient treated with IgM-enriched immunoglobulins, the cost per life saved is 2214€. Two studies showed that the ICU length of stay is 2.5 days shorter for pediatric patients treated with IgM-enriched immunoglobulins compared to standard treatment, which yields additional cost savings of 5000€ in Germany.

CONCLUSIONS: The findings suggest that the treatment of septic patients with IgM-enriched immunoglobulins is cost-effective. Therefore IgM-enriched immunoglobulins can be recommended as adjunctive treatment of patients with sepsis.