Cost-effectiveness of GRAZAX® for prevention of grass pollen induced rhinoconjunctivitis in Southern Europe

Canonica, Giorgio Walter; Poulsen, PB; Vestenbaek, Ulrik

doi:10.1016/j.rmed.2007.05.003

Cited by 57 publications

(52 citation statements)

References 40 publications

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“…Interestingly, our results shown in Figure 2 point out the lowest annual price of SLIT treatment, corresponding to €1.532 (Ϯ333.8) and €769.1 (Ϯ74.83) in the first and third years, respectively, compared with an annual price of €1,550 to €1,900 found in a prospective pharmacoeconomic analysis of the tablet SLIT preparation in patients with grass pollen-associated rhinitis living in 4 southern European countries (Spain, France, Italy, and Austria). 32 Our results are very close to those of a study recently conducted in France concerning a cost-efficacy analysis on the comparison of immunotherapy (subcutaneous and sublingual) and current symptomatic treatment in adults and children with dust mite and pollen allergy. 25 As expected, SLIT, because of no need of visits for injections, yielded a higher cost savings with regard not only to SCIT but also to drugs, especially in pollen-allergic patients (both adults and chil- dren).…”

Section: Discussionsupporting

confidence: 87%

“…24 The economic aspects of SLIT have also been evaluated in 2 recent SLIT studies performed with oral tablets for grass pollen in northern Europe 31 and southern Europe. 32 In the first study, a societal perspective was adopted, and the evaluation of cost-effectiveness of SLIT compared with use of symptomatic drugs in a 9-year time horizon analysis was performed in 7 northern European countries. 31 In this study, the main outcome measure was quality-adjusted life years as an index of health-related quality of life, whereas we used a simpler measure (VAS, recently validated in its evaluation capacity), 29 but the 2 pharmacoeconomic evaluations are in agreement.…”

Section: Discussionmentioning

confidence: 99%

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Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma

Ariano

Berto

Incorvaia

et al. 2009

Annals of Allergy, Asthma & Immunology

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Background:The worldwide increased prevalence of allergic diseases, and especially of respiratory allergy, is paralleled by increased health costs. This requires consideration of the cost to efficacy ratio of the available treatment to identify the optimal choice.Objective: To compare the different economic relevance, over a long evaluation time, of symptomatic pharmacologic therapy and sublingual immunotherapy (SLIT) in patients with allergic asthma.Methods: Seventy patients with perennial allergic asthma, sensitized to dust mites, were enrolled; 50 of these patients were treated with SLIT against house dust mites and 20 were treated with symptomatic drugs. The patients were evaluated for 2 years after discontinuing immunotherapy, which was performed for 3 years, to obtain a more complete follow-up. Symptom scores, medication scores, and all other direct medical costs were evaluated with a specific questionnaire.Results: Patients treated with SLIT plus drugs had a higher mean annual cost in the first year of SLIT treatment compared with patients only receiving drug treatment, but the mean annual cost became significantly lower since the end of SLIT both in the whole population and in the subgroups defined by disease severity. Conclusion:The economic advantage measured alongside this prospective observational study was long lasting and still present at the fifth year of the follow-up (2 years after discontinuing SLIT) and could positively be related to the persistent good clinical control of patients.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma

Ariano

Berto

Incorvaia

et al. 2009

Annals of Allergy, Asthma & Immunology

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“…Ten studies, reported in 13 publications, used the EuroQol instrument, and reported either the European Quality of Life-5 Dimensions (EQ-5D) utility score [62][63][64][65][66][67] or the visual analogue scale (VAS) score. [68][69][70][71][72][73] One study reported utilities obtained by the HUI Mark III instrument.…”

Section: Resultsmentioning

confidence: 99%

“…74 Three studies used a direct utility elicitation technique. [75][76][77] The 10 studies reported on 28 populations: 14 studies with rhinitis/rhinosinusitis/ rhinoconjunctivitis/asthma, [62][63][64][65][66][68][69][70][71][72][73]78 11 studies with eczema, 67,73,[75][76][77] two studies with food allergy 73,74 and one study with mixed allergies except food allergies. 74 Utility values ranged from 0.5000 for patients with allergic rhinitis receiving allergy vaccination 72 to 0.970 for persons with mild eczema.…”

Section: Resultsmentioning

confidence: 99%

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ImmunoCAP® ISAC and Microtest for multiplex allergen testing in people with difficult to manage allergic disease: a systematic review and cost analysis

Westwood

Ramaekers

Lang

et al. 2016

Health Technol Assess

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BackgroundAllergy is a form of immune-mediated exaggerated sensitivity (hypersensitivity) to a substance that is either inhaled, swallowed, injected or comes into contact with the skin. Foreign substances that provoke allergies are called allergens. It has been claimed that multiplex allergen testing may help in diagnosing the cause of symptoms in patients with an unclear cause of allergy or who are allergic to more than one substance.ObjectivesTo evaluate multiplex allergen testing [devices that can measure the presence of multiple immunoglobulin E (IgE) antibodies in a patient’s blood at the same time], by assessing (1) clinical effectiveness (allergy symptoms, incidence of acute exacerbations, mortality, adverse events of testing and treatment, health-care presentations or admissions, health-related quality of life); (2) effects on treatment (diet, immunotherapy medications, other potential testing); (3) any additional diagnostic information provided by multiplex allergen testing; and (4) cost-effectiveness (cost of different assessment strategies).MethodsFifteen databases were searched from 2005 to April 2015, including MEDLINE (via OvidSp), MEDLINE In-Process Citations, MEDLINE Daily Update, PubMed (National Library of Medicine), EMBASE, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, Science Citation Index (SCI), Conference Proceedings Citation Index-Science (CPCI-S), BIOSIS Previews, Latin American and Caribbean Health Sciences Literature (LILACS), National Institute for Health Research (NIHR) HTA programme, and the US Food and Drug Administration (FDA); supplementary searches of conference proceedings and trials registries were performed. Review methods followed published guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination, University of York, UK. The methodological quality of included studies was assessed using appropriate published tools or a review-specific tool designed by the project team. Studies were summarised in a narrative synthesis. Owing to a lack of data on the clinical effectiveness of multiplex allergen testing, no long-term cost-effectiveness model was developed. A conceptual model structure was developed and cost analyses were performed to examine the short-term costs of various possible diagnostic pathways.ResultsFifteen studies were included in the review. The very limited available data indicated that the addition of multiplex allergen testing [ImmunoCAP®Immuno Solid-phase Allergen Chip (ISAC), Thermo Fisher Scientific/Phadia AB, Uppsala, Sweden] to standard diagnostic work-up can change the clinicians’ views on the diagnosis, management and treatment of patients. There was some indication that the use of ImmunoCAP ISAC testing may be useful to guide decisions on the discontinuation of restrictive diets, the content of allergen-specific immunotherapy (SIT) prescriptions, and whether or not patients should receive SIT. However, none of the studies that we identified reported any information on clinical outcomes subsequent to changes in treatment or management. There was some evidence that ImmunoCAP ISAC may be useful for discriminating allergens that are structurally similar and are recognised by the same IgE antibody (cross-immunoreactive). No data were available for Microtest (Microtest Matrices Ltd, London, UK). Detailed cost analyses suggested that multiplex allergen testing would have to result in a substantial reduction of the proportions of patients receiving single IgE testing and oral food challenge tests in order to be cost-saving in the short term.ConclusionsNo recommendations for service provision can be made based on the analyses included in this report. It is suggested that a consensus-based protocol for the use of multiplex allergen testing be developed. The clinical effectiveness and cost-effectiveness of the proposed protocol should then be assessed by comparing long-term clinical and quality of life outcomes and resource use in patients managed using the protocol with those managed using a standard diagnostic pathway.Study registrationThis study is registered as PROSPERO CRD42015019739.FundingThis project was a Diagnostic Assessment Report commissioned by the NIHR HTA programme on behalf of the National Institute for Health and Care Excellence.

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Allergen Immunotherapy and Atopic Dermatitis: the Good, the Bad, and the Unknown

Rizk

Rodenas

Benedetto

2019

Curr Allergy Asthma Rep

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Cost-effectiveness of GRAZAX® for prevention of grass pollen induced rhinoconjunctivitis in Southern Europe

Abstract: The analysis illustrates that allergen SIT with Grazax for grass pollen induced rhinoconjunctivitis is a cost-effective intervention in Southern Europe.

Cited by 57 publications

References 40 publications

Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma

Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma

ImmunoCAP® ISAC and Microtest for multiplex allergen testing in people with difficult to manage allergic disease: a systematic review and cost analysis

Allergen Immunotherapy and Atopic Dermatitis: the Good, the Bad, and the Unknown

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