OBJECTIVES: To assess the cost-effectiveness of drotecogin alfa activated (DAA) compared to standard therapy (ST) in severe sepsis in Poland. METHODS: Data on clinical effectiveness and resources used were derived from Polish Severe Sepsis Registry (SSR) of patients hospitalized in 108 ICUs from 1st April 2003 to 2nd April 2004. The effectiveness was defined as the ICU stay survival and life year gained. Only direct medical ICUs costs were analyzed. Unit costs were calculated using drugs retail prices, hospital accounts systems data and medical procedures tariffs contracted by National Health Found. The cost-effectiveness was assessed based on raw survival rates and mean treatment costs for the DAA and ST groups as documented in SSR. Additionally regression model on effectiveness and associated costs was constructed to control for case-mix. Costs are expressed in PLN (1PLN=0.4808€ PPP’2003). RESULTS: The rate of ICUs survival amounted to 61% and 44% for the DAA and ST group, respectively. The corresponding mean costs amounted to 98,987 PLN (47,593€) and 49,568 PLN (23,832€). Based on raw data from SSR the additional cost per one death avoided with DAA was calculated on 284,557 PLN (136,815€). In regression model DAA was found to significantly increase the survival rate (OR=2.651;95%CI:1.67-4.21) resulting in 4.93 (95%CI:2.68-6.96) life years gained per patient. Thus the additional cost per one death avoided and cost per life year gained with DAA amounted to 183,019 PLN (87,996€) and 7,487 PLN (3,600€), respectively. CONCLUSIONS: DAA is cost-effective in severe sepsis treatment.