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Cost-effectiveness of SQ® HDM SLIT-tablet in addition to pharmacotherapy for the treatment of house dust mite allergic rhinitis in Germany

Authors Green W, Kleine-Tebbe J, Klimek L, Hahn-Pedersen J, Nørgaard Andreasen J, Taylor M

Received 27 June 2016

Accepted for publication 20 October 2016

Published 16 February 2017 Volume 2017:9 Pages 77—84


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Samer Hamidi

William Green,1 Jörg Kleine-Tebbe,2 Ludger Klimek,3 Julie Hahn-Pedersen,4 Jakob Nørgaard Andreasen,4 Matthew Taylor1

1York Health Economics Consortium, University of York, York, UK; 2Allergy and Asthma Center, Westend, Berlin, 3Center for Rhinology and Allergology, Wiesbaden, Germany; 4ALK-Abelló, Hørsholm, Denmark

Background: Allergic rhinitis is a global health problem that burdens society due to associated health care costs and its impact on health. Standardized quality (SQ®) house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet is a sublingually administered allergy immunotherapy tablet for patients with persistent moderate to severe HDM allergic rhinitis despite use of allergy pharmacotherapy.
Objective: To assess the cost-effectiveness of SQ HDM SLIT-tablet in Germany for patients suffering from HDM allergic rhinitis.
Methods: A pharmacoeconomic analysis, based on data collected in a double-blinded, phase III randomized placebo-controlled trial (n=992), was undertaken to compare SQ HDM SLIT-tablet in addition to allergy pharmacotherapy to placebo plus allergy pharmacotherapy. Quality-adjusted life year (QALY) scores and health care resource use data recorded in the trial were applied to each treatment group and extrapolated over a nine-year time horizon. A series of scenarios were used to investigate the impact of changes on long-term patient health for both treatment groups, which was measured by annual changes in QALY scores. Deterministic and probabilistic sensitivity analyses were also performed.
Results: In the base case analysis, compared with allergy pharmacotherapy, SQ HDM SLIT-tablet led to a QALY gain of 0.31 at an incremental cost of €2,276 over the nine-year time horizon, equating to an incremental cost-effectiveness ratio of €7,519. The treatment was cost-effective for all scenarios analyzed; however, results were sensitive to changes in individual parameter values during the deterministic sensitivity analysis.
Conclusion: SQ HDM SLIT-tablet in addition to pharmacotherapy is cost-effective compared with allergy pharmacotherapy plus placebo for the treatment of persistent moderate to severe HDM allergic rhinitis that is not well controlled by allergy pharmacotherapy.

Keywords: SQ HDM SLIT-tablet, allergic rhinitis, house dust mite, cost-utility analysis

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