[Economic evaluation of a tablet-based vaccination against hay fever in Denmark].
BACKGROUND
Hay fever (allergic rhinoconjunctivitis) is a frequent disease and 12% of the Danish adult population suffer from grass-pollen induced hay fever. Symptomatic medication is the traditional treatment, while immunotherapy with sustained effect is an alternative. Grazax (Phleum pratense, ALK-Abelló) is a new tablet-based vaccination against grass-pollen induced hay fever. The aim was to investigate the cost-effectiveness of the tablet-based vaccination of grass-pollen induced hay fever in Denmark.


METHODS
Based on a prospective collection of data as part of a clinical trial cost and quality of life (QALY) data for 493 patients, the tablet-based vaccine (Grazax) was compared in a cost-utility analysis (societal perspective) with symptomatic treatment. The analysis was based on three years of immunotherapy followed by six years of sustained effect.


RESULTS
Significant more QALYs were gained from using the tablet-based vaccine (0.9799) compared with traditional symptomatic treatment (0.9567), which with a nine-year time horizon corresponds to 0.19 extra QALYs. The costs of vaccination against hay fever were DKK 34,498. With a nine-year time horizon, the cost per extra QALY from using the tablet-based vaccine was DKK 52,646 or DKK 134,105, focussing on direct costs alone. These results are below the unofficial thresholds for what the costs of a QALY should be.


CONCLUSIONS
The analysis has shown that tablet-based immunotherapy (Grazax) for the treatment of hay fever results in an improved quality of life and that it is a cost-effective choice.
Poulsen
Peter Bo
PB
MUUSMANN Research & Consulting, Kolding Syddansk Universitet Odense, Institut for Sundhedstjenesteforskning Sundhedsøkonomi, Kolding. pbpo@muusmann-as.dk
Pedersen
Kjeld Møller
KM
Christensen
Jens
J
Vestenbaek
Ulrik
U
D000286:Administration, Sublingual; D000328:Adult; D000485:Allergens / Q000008:administration & dosage* / Q000191:economics; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D003888:Desensitization, Immunologic / Q000191:economics / Q000379:methods; D016527:Drug Costs; D006801:Humans; D006109:Poaceae / Q000276:immunology; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D006255:Rhinitis, Allergic, Seasonal / Q000517:prevention & control*; D013607:Tablets; D014612:Vaccines / Q000008:administration & dosage* / Q000191:economics
D000485:Allergens; D018926:Anti-Allergic Agents; D013607:Tablets; D014612:Vaccines