A Cost-Minimisation Analysis Comparing Sublingual Immunotherapy to Subcutaneous Immunotherapy for the Treatment of House Dust Mite Allergy in a Swedish Setting.
OBJECTIVE
In Sweden, approximately 6% of children and 10% of adults suffer from house dust mite (HDM) allergy with symptoms of allergic rhinitis and allergic asthma. Treatment is aimed at reducing HDM exposure and to control the symptoms of allergic rhinitis and allergic asthma by symptom-relieving pharmacotherapy. This pharmacotherapy is often effective, but some patients remain inadequately controlled. For these patients, allergy immunotherapy (AIT, subcutaneous or sublingual) with repeated administration of HDM allergen should be considered. The objective of this study was to compare the costs for sublingual AIT (SLIT; SQ®SLIT-tablet) to the costs for subcutaneous AIT (SCIT; SQ®SCIT) for the treatment of HDM allergy in a cost-minimisation analysis (CMA).


METHODS
The CMA included resources (and costs) for treatment, healthcare visits, travelling and lost productivity. Resource use based on Swedish clinical treatment practice and costs were obtained from medical price lists. Analyses were conducted from the societal, as well as healthcare perspective, by use of a time horizon of 3 years.


RESULTS
The results show that SQ®SLIT-tablet is a cost-saving treatment as compared to SQ®SCIT for the treatment of HDM allergy (€6800 over 3 years). The results are mainly driven by the cost of healthcare visits and the frequency of SCIT administrations.


CONCLUSIONS
In conclusion, cost-savings of €6800 over 3 years are expected from treating HDM allergy with SQ®SLIT-tablet as compared to SQ®SCIT, including costs for treatment, healthcare visits, travelling and lost productivity. The reduced number of healthcare visits compensates for higher medication costs.
Nordic Health Economics AB, Gothenburg, Sweden. ase.bjorstad@nordichealtheconomics.se.
Åse
http://orcid.org/0000-0001-9670-8203
Å
Björstad
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.|Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden.
Lars-Olaf
LO
Cardell
ALK, Hørsholm, Denmark.
Julie
J
Hahn-Pedersen
ALK, Kungsbacka, Sweden.
Mikael
M
Svärd
D000818:Animals; D001249:Asthma / Q000628:therapy*; D017046:Cost Savings; D003888:Desensitization, Immunologic; D006801:Humans; D007279:Injections, Subcutaneous; D039981:Pyroglyphidae / Q000276:immunology*; D065631:Rhinitis, Allergic / Q000628:therapy*; D063729:Sublingual Immunotherapy