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Cost-Effectiveness Of The SQ® Grass SLIT-Tablet In Children With Allergic Rhinitis: A German Payer Perspective

Authors Vogelberg C, Hamelmann E, Wahn U, Domdey A, Pollock RF, Grand TS

Received 16 July 2019

Accepted for publication 11 October 2019

Published 6 November 2019 Volume 2019:11 Pages 637—649

DOI https://doi.org/10.2147/CEOR.S223383

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo


Christian Vogelberg,1 Eckard Hamelmann,2 Ulrich Wahn,3 Anne Domdey,4 Richard F Pollock,5 Tobias S Grand4

1Technische Universität Dresden, Dresden, Germany; 2Klinik Für Kinder- und Jugendmedizin, Evangelisches Klinikum Bethel GmbH, Akademisches Lehrkrankenhaus der Universität Münster, Bielefeld, Germany; 3Klinik Für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité, Berlin, Germany; 4ALK-Abelló A/S, Hørsholm, Denmark; 5Covalence Research Ltd, London, UK

Correspondence: Tobias S Grand
ALK-Abelló A/S, Hørsholm, Denmark
Tel +45 45 74 75 76
Email Tobias.SydendalGrand@alk.net

Background: The Grazax Asthma Prevention (GAP) trial has recently demonstrated significant reductions in the odds of asthma symptoms or medication use in patients treated with SQ® grass SLIT-tablet relative to placebo, both in combination with allergy and asthma pharmacotherapy. The objective of the present analysis was to evaluate the cost-effectiveness of SQ grass SLIT-tablet relative to placebo in children with AR from the perspective of a German healthcare payer.
Methods: A cost-utility model was developed in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) to evaluate the cost-utility of SQ grass SLIT-tablet in combination with pharmacotherapy versus pharmacotherapy alone in patients with AR. Transition probabilities were derived from the GAP trial, and costs were taken from a real-world insurance database analysis. Future costs and effects were discounted at 3% per annum, and extensive deterministic and probabilistic sensitivity analyses were performed.
Results: Over a 10-year time horizon, the base case analysis showed an increase in overall treatment costs of €897 per child being treated with SQ grass SLIT-tablet relative to pharmacotherapy alone. The increased treatment costs were accompanied by an improvement in patient quality of life of 0.10 quality-adjusted life years (QALYs) yielding an ICER of €8978 per QALY gained, falling well below a willingness-to-pay threshold of €17,800 per QALY gained. The base case results were insensitive to changes in all individual model parameters.
Discussion: Improvements in quality of life with the SQ grass SLIT-tablet would be accompanied by only a modest increase in costs over a 10-year time horizon, with the SQ grass SLIT-tablet therefore representing excellent value for money from the German healthcare payer perspective.

Keywords: rhinitis, allergic, asthma, costs and cost analysis, Germany
 

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