Record Details

The use of dexmedetomidine in intensive care sedation

Farmeconomia

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Title The use of dexmedetomidine in intensive care sedation
 
Creator Antonelli, Massimo
Conti, Giorgio
Belisari, Andrea
D'Angiolella, Lucia S.
Mantovani, Lorenzo
Montella, Sabato
Piacentini, Patrizio
Ranieri, Marco
 
Subject HTA
Dexmedetomidine, Health Tecnology Assessment; Intensive care; Sedation
 
Description The goals and recommendations for ICU (Intensive Care Unit) patients’ sedation and analgesia should be to have adequately sedated patients who are calm and arousal, so that they can guarantee a proper evaluation and an adequate control of pain. This way, it is also possible to perform their neurological evaluation, preserving intellectual faculties and helping them in actively participating to their care. Dexmedetomidine is a selective alpha-2 receptor agonist, member of theraputical cathegory: “other hypnotics and sedatives” (ATC: N05CM18). Dexmedetomidine is recommended for the sedation of adult ICU patients who need a sedation level not deeper than arousal in response to verbal stimulation (corresponding to Richmond Agitation-Sedation Scale 0 to -3). After the EMA approval, some European government authorities have elaborated HTA on dexmedetomidine, based on clinical evidence derived from Prodex and Midex trials. Dexmedetomidine resulted to be as effective as propofol and midazolam in maintaining the target depth of sedation in ICU patients. The mean duration of mechanical ventilation with dexmedetomidine was numerically shorter than with propofol and significantly shorter than with midazolam. The resulting favourable economic profile of dexmedetomidine supported the clinical use in ICU. Dexmedetomidine seems to provide clinical benefits due to the reduction of mechanical ventilation and ventilator weaning duration. Within the present review, an economic analysis of costs associated to the use of dexmedetomidine was therefore performed also in the Italian care setting. Thus, four different analyses were carried out based on the quantification of the total number of days in ICU, the time spent on mechanical ventilation, the weighted average number of days with mechanical ventilation or not and TISS points (Therapeutic Intervention Scoring System). Despite the incremental cost for drug therapy associated with dexmedetomidine, a reduction of the management costs for ICU has been estimated, with savings ranging between € 800 and € 1,400 per patient. 
 
Publisher SEEd
 
Contributor Il presente lavoro è stato supportato da ORION PHARMA s.r.l.
 
Date 2013-05-28
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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Format text/html
application/pdf
 
Identifier http://journals.edizioniseed.it/index.php/FE/article/view/674
10.7175/fe.v14i1S.674
 
Source Farmeconomia. Health economics and therapeutic pathways; Vol 14, No 1S (2013); 1-28
2240-256X
1721-6915
 
Language eng
 
Relation http://journals.edizioniseed.it/index.php/FE/article/view/674/759
http://journals.edizioniseed.it/index.php/FE/article/view/674/760
 
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