C. Mylonas, N. Maniadakis, N. Kitsioulis, P. Xepapadaki, N. G. Papadopoulos
Introduction: Allergen immunotherapy (AIT) is a commonly treatment that decreases symptoms for people with allergic rhinitis (AR) and asthma (AA). Despite the wide use of AIT, the economic evaluation of AIT versus symptomatic treatment has not been well established.
Objective: To conduct a cost-effectiveness (CE) analysis of subcutaneous immunotherapy (SCIT) versus symptomatic treatment for AR and AA, in the Greek health care setting. The consequences of treatments were evaluated from a 3rdparty payer perspective in a 10-year time horizon.
Method: A Decision tree model was used to reflect the natural progression and evaluate the CE of the comparators. Efficacy and safety data considered in the model were extracted from literature review and published studies. Utilities values were extracted from the literature. Direct costs were incorporated in the model reflecting the year 2018. Probabilistic sensitivity analysis was conducted to account for uncertainty and variation in the parameters of the model.
Results: Discounted survival and quality adjusted survival of SCIT treated patients was higher compared to symptomatic treatment by 1.51 lifeyears and 0.89 QALYs. SCIT was more costly in terms of drug acquisition medications, but the total cost per patient was less costly for SCIT, due to lower cost of management of AR and AA. The total cost per patient was estimated at 7,522€, for SCIT and for symptomatic treatment at 10,230€. Probabilistic analysis confirmed the deterministic results.
Conclusion: Results suggest that SCIT may be a dominant alternative relative to symptomatic treatment in the treatment of patients with AR and AA.