Cost-effectiveness of vasopressin in the treatment of septic shock: insights from a European societal perspective

Septic shock is a life-threatening condition associated with high morbidity, mortality, and healthcare costs. Vasopressin (VA) is recommended as a second-line vasopressor in septic shock, but its cost-effectiveness—especially regarding the timing of administration—remains unclear in European settings. A hybrid decision-analytic model combining a short-term decision tree and a long-term Markov model was developed to evaluate the cost-effectiveness of VA in adult patients with septic shock. The analysis was conducted from both a healthcare payer and societal perspective. Clinical efficacy inputs were derived from high-quality meta-analyses and systematic reviews. The model incorporated health-states such as end-stage renal-disease (ESRD) with need for renal replacement therapy (RRT), atrial fibrillation (AF), and mortality over a lifetime horizon. Two comparisons were analyzed: VA versus No VA, and early (within 3–12 h of shock onset) versus late VA administration. Outcomes included incremental cost-effectiveness ratio (ICER), life-years (LYs), quality-adjusted life-years (QALYs), and direct and indirect cost estimates. Adding VA was a dominant strategy, improving clinical outcomes while reducing lifetime costs by 10,570 €per patient and yielding 0.09 additional QALYs. VA therapy reduced RRT dependence by 2.5% and increased AF-free survival by 6.2%. Early VA administration was even more cost-effective, providing 0.55 additional QALYs, 0.77 extra LYs, and 4,746 €in additional savings compared to late administration. Second-line VA is a cost-effective intervention for septic shock, notably when initiated early. These findings support guideline recommendations for early vasopressor use and emphasize the clinical and economic value of timely VA therapy. Sepsis and septic shock are severe, life-threatening conditions that can cause organ failure, heart rhythm problems, and long-term health consequences. These complications often lead to high healthcare costs and loss of productivity for patients and society. Vasopressin is a medication recommended as an additional treatment when standard therapy does not sufficiently stabilize blood pressure, but its long-term economic value has been unclear.This study evaluated the health outcomes and lifetime costs of using vasopressin in patients with septic shock in Europe. It compared two approaches: adding vasopressin to standard treatment versus not using vasopressin, and starting vasopressin early (within 3–12 hours after shock onset) versus starting it later. The analysis considered survival, quality of life, need for long-term dialysis, heart rhythm disorders, healthcare costs, and productivity losses across five European countries.Results showed that adding vasopressin improved patient outcomes while reducing overall costs compared with not using vasopressin. Early use of vasopressin provided even greater benefits, including longer survival, better quality of life, fewer patients needing long-term dialysis, fewer heart rhythm complications, and lower total costs. These findings suggest that early vasopressin use in septic shock can improve patient outcomes while reducing the economic burden on healthcare systems and society. Sepsis and septic shock are severe, life-threatening conditions that can cause organ failure, heart rhythm problems, and long-term health consequences. These complications often lead to high healthcare costs and loss of productivity for patients and society. Vasopressin is a medication recommended as an additional treatment when standard therapy does not sufficiently stabilize blood pressure, but its long-term economic value has been unclear. This study evaluated the health outcomes and lifetime costs of using vasopressin in patients with septic shock in Europe. It compared two approaches: adding vasopressin to standard treatment versus not using vasopressin, and starting vasopressin early (within 3–12 hours after shock onset) versus starting it later. The analysis considered survival, quality of life, need for long-term dialysis, heart rhythm disorders, healthcare costs, and productivity losses across five European countries. Results showed that adding vasopressin improved patient outcomes while reducing overall costs compared with not using vasopressin. Early use of vasopressin provided even greater benefits, including longer survival, better quality of life, fewer patients needing long-term dialysis, fewer heart rhythm complications, and lower total costs. These findings suggest that early vasopressin use in septic shock can improve patient outcomes while reducing the economic burden on healthcare systems and society.