Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma

Abstract

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.

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

“…Compared with patients receiving SDT alone, mean, annual per-patient costs (SLIT plus allergy-related medications) incurred by the patients receiving SLIT plus SDT were higher in year 1, equivalent in years 2 and 3, and significantly lower in years 4 and 5, with a net saving of 23%. The year 5 savings, in terms of annual per-patient incremental costs that were achieved by patients receiving SLIT plus SDT, increased with disease severity and reached 34% for severe asthmatic patients [228].…”

“…The difference was even greater when future costs of asthma were included [226,227]. Ariano et al [228] conducted a costconsequence analysis alongside a prospective study of patients with allergic asthma due to HDM. Fifty patients received a 3-year course of SLIT plus SDT and 20 SDT alone.…”

Chinese Guideline on allergen immunotherapy for allergic rhinitis

“…Several individual studies and systematic reviews have been published, which suggests that immunotherapy is cost-effective as compared with standard symptomatic pharmacotherapy for AR and AR accompanied with asthma (ARAS) (61)(62)(63)(64)(65)(66)(67). These studies have consistently concluded that immunotherapy for 3 years was cost effective compared to pharmacotherapy with regard to symptom scores and quality of life improvements.…”

“…These studies have consistently concluded that immunotherapy for 3 years was cost effective compared to pharmacotherapy with regard to symptom scores and quality of life improvements. Indeed, evidence indicates that immunotherapy is more cost-effective than standard symptomatic treatment when the social perspective and costs of productivity loss are taken into account (61)(62)(63)(64)(65)(66)(67). Furthermore, the cost effectiveness of immunotherapy is likely to be of greater magnitude when the long-term efficacy after termination of AIT treatment and the preventive effects of AIT on development of asthma and new sensitizations to allergens are considered (68)(69)(70)(71).…”

Sublingual Immunotherapy in Patients with Allergic Rhinoconjunctivitis

“…An economic evaluation of SLIT was conducted by Ariano et al [11]. They compared the different economic aspects of symptomatic pharmacologic therapy and SLIT in patients with allergic asthma.…”