L'impact de l'Immunothérapie Spécifique sur les coûts directs de la maladie allergique : une étude pragmatique

Pen, Claude Le; Rumeau-Pichon, Catherine; Lilliu, H

doi:10.1016/s0335-7457(97)80116-5

Cited by 3 publications

(3 citation statements)

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“…Another late 1990s German retrospective study analyzed the economic effects of 3 years of subcutaneous AIT modeling results over a follow-up of 10 years and found that advantages of AIT on drug treatment started after 6 years and resulted in final net savings of between 650 and 1190 DM per patient (€ 332 and € 608) [27]; a sensitivity analysis on direct medical costs showed that AIT was more likely to result in net savings than in additional costs. In this study the economic benefit was clear but the break-even point, that is the time at which the overall cost of treatment for AIT patients becomes lower than for patients receiving only drugs, was reached only 3 years after discontinuing AIT, while in a French study a significant reduction of the direct costs of allergic disease yet after 2 years of immunotherapy was reported [28].…”

Section: Studies On Subcutaneous Immunotherapymentioning

confidence: 58%

Cost-Effectiveness of Allergen Immunotherapy

Incorvaia¹

2012

J Aller Ther

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The current burden of allergic diseases, considering both direct and indirect costs, is very relevant. In fact the estimated cost for allergic rhinitis (AR) is 4-10 billion dollars/year in the US and averages an annual cost of 1089 euros per child/adolescent and 1543 euros per adult in Europe. The cost is obviously higher when including also allergic asthma. Strategies aimed at reducing the clinical severity of allergy are therefore most relevant from both a societal and healthcare system's perspective. Among them, allergen immunotherapy (AIT) showed preventive capacity and also a carryover effect once treatment is discontinued, thus further reducing the costs. A number of studies demonstrated a favorable cost-benefit ratio for AIT. The first studies in the 1990s evaluating subcutaneous AIT in patients with allergic rhinitis and asthma, reported significant reductions of direct and indirect costs in subjects treated with AIT, as compared to those treated with symptomatic drugs. This was fully confirmed in recent studies conducted in European countries, also including sublingual immunotherapy, as well as in studies conducted in the US. In particular, the conclusion of a recent study on health care cost benefits of AIT in children with AR suggesting that "Greater use of this treatment in children could significantly reduce AR-related morbidity and its economic burden" should be kept in mind when considering the optimal choice of medical treatment in patients with AR or asthma.

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Section: Studies On Subcutaneous Immunotherapymentioning

confidence: 58%

Cost-Effectiveness of Allergen Immunotherapy

Incorvaia¹

2012

J Aller Ther

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“…Specifically addressed pharmacoeconomic studies on subcutaneous immunotherapy (SCIT) in patients with rhinitis and asthma have been available since the mid-1990s [13][14][15][16][17][18][19][20][21] ; recently, some studies, mostly conducted on patients with seasonal allergy, also analyzed the effects of SLIT on health expenditures. [22][23][24][25] The aim of the present study was to estimate, during a long period, the economic value of symptomatic drug therapy and SLIT in adult patients with rhinitis and asthma, sensitized to house dust mites.…”

Section: Introductionmentioning

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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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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“…Health economics studies of SCIT conducted outside the United States include findings from prospective clinical trials of AR-diagnosed adults with or without asthma conducted in Italy and the Czech Republic 1,3 ; patient and physician questionnaires obtained from allergy clinics in Denmark and France 4,7 ; and decision-tree and Markov cost-effectiveness models developed in France and Germany based on data derived from systematic literature reviews, Delphi panels, and retrospective claims analyses (Table II). 14,16-18 SCIT has been consistently shown to be cost saving and cost effective, 1,3,7,14,[16][17][18] with the exception of 1 study. 4 This anomalous study had significant disadvantages: (1) data were based on patient recall of health care use for up to 7 previous years; (2) drug use was restricted to allergy or asthma medications and did not include antibiotics or other medications that may serve as clinically meaningful signals of treatment effect; and (3) annual medication use, which was projected from 7 months of actual data that included the peak grass pollen season, may have overestimated actual use of medications.…”

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confidence: 99%