Cost-effectiveness of specific subcutaneous immunotherapy in patients with allergic rhinitis and allergic asthma
| Autor: | Ulrich Machate, Bernd Brüggenjürgen, Randolf Brehler, Günther Wiese, Eckard Laake, Stefan N. Willich, Thomas Reinhold |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Pediatrics Allergy Rhinitis Allergic Perennial Adolescent Cost effectiveness Cost-Benefit Analysis Injections Subcutaneous Immunology Context (language use) Germany Health care medicine Humans Immunology and Allergy Child health care economics and organizations Asthma Cost–benefit analysis business.industry Rhinitis Allergic Seasonal Middle Aged medicine.disease Markov Chains Surgery Treatment Outcome Otorhinolaryngology Desensitization Immunologic Concomitant business Algorithms |
| Zdroj: | Annals of Allergy, Asthma & Immunology. 101:316-324 |
| ISSN: | 1081-1206 |
| Popis: | Background Specific immunotherapy is the only potentially curative treatment in patients with allergic rhinitis and allergic asthma. Health economic evaluations on this treatment, particularly in a German context, are sparse. Objective To evaluate the cost-effectiveness of specific subcutaneous immunotherapy (SCIT) in addition to symptomatic treatment (ST) compared with ST alone in a German health care setting. Methods The analysis was performed as a health economic model calculation based on Markov models. In addition, we performed a concomitant expert board composed of allergy experts in pediatrics, dermatology, pneumology, and otolaryngology. The primary perspective of the study was societal. Additional sensitivity analyses were performed to prove our results for robustness. Results The SCIT and ST combination was associated with annual cost savings of €140 per patient. After 10 years of disease duration, SCIT and ST reach the breakeven point. The overall incremental cost-effectiveness ratio (ICER) was €−19,787 per quality-adjusted life-year (QALY), with a range that depended on patient age (adults, €−22,196; adolescents, €−14,747; children, €−12,750). From a third-party payer's perspective, SCIT was associated with slightly additional costs. Thus, the resulting ICER was €8,308 per QALY for all patients. Conclusions Additional SCIT was associated with improved medical outcomes and cost savings compared with symptomatic treatment alone according to a societal perspective. Taking a European accepted ICER threshold of up to €50,000 per QALY into account, additional SCIT is considered clearly cost-effective compared with routine care in Germany. The degree of cost-effectiveness is strongly affected by costs related to SCIT and the target population receiving such treatment. |
| Databáze: | OpenAIRE |
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