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Published in: The European Journal of Health Economics 9/2018

01-12-2018 | Original Research

Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach

Authors: Ann-Kathrin Richter, Ludger Klimek, Hans F. Merk, Norbert Mülleneisen, Harald Renz, Wolfgang Wehrmann, Thomas Werfel, Eckard Hamelmann, Uwe Siebert, Gaby Sroczynski, Jürgen Wasem, Janine Biermann-Stallwitz

Published in: The European Journal of Health Economics | Issue 9/2018

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Abstract

Background

Specific immunotherapy is the only causal treatment in respiratory allergy. Due to high treatment cost and possible severe side effects subcutaneous immunotherapy (SCIT) is not indicated in all patients. Nevertheless, reported treatment rates seem to be low. This study aims to analyze the effects of increasing treatment rates of SCIT in respiratory allergy in terms of costs and quality-adjusted life years (QALYs).

Methods

A state-transition Markov model simulates the course of disease of patients with allergic rhinitis, allergic asthma and both diseases over 10 years including a symptom-free state and death. Treatment comprises symptomatic pharmacotherapy alone or combined with SCIT. The model compares two strategies of increased and status quo treatment rates. Transition probabilities are based on routine data. Costs are calculated from the societal perspective applying German unit costs to literature-derived resource consumption. QALYs are determined by translating the mean change in non-preference-based quality of life scores to a change in utility. Key parameters are subjected to deterministic sensitivity analyses.

Results

Increasing treatment rates is a cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of 3484€/QALY compared to the status quo. The most influential parameters are SCIT discontinuation rates, treatment effects on the transition probabilities and cost of SCIT. Across all parameter variations, the best case leads to dominance of increased treatment rates while the worst case ICER is 34,315€/QALY. Excluding indirect cost leads to a twofold increase in the ICER.

Conclusions

Measures to increase SCIT initiation rates should be implemented and also address improving adherence.
Appendix
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Literature
1.
go back to reference Chivato, T., Valovirta, E., Dahl, R., de Monchy, J., Bloch Thomsen, A., Palkonen, S., Jacobsen, L.: Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe. J. Investig. Allergol. Clin. Immunol. 22(3), 168–179 (2012)PubMed Chivato, T., Valovirta, E., Dahl, R., de Monchy, J., Bloch Thomsen, A., Palkonen, S., Jacobsen, L.: Allergy, living and learning: diagnosis and treatment of allergic respiratory diseases in Europe. J. Investig. Allergol. Clin. Immunol. 22(3), 168–179 (2012)PubMed
2.
go back to reference Petersen, K.D., Kronborg, C., Gyrd-Hansen, D., Dahl, R., Larsen, J.N., Lowenstein, H.: Quality of life in rhinoconjunctivitis assessed with generic and disease-specific questionnaires. Allergy 63(3), 284–291 (2008)CrossRef Petersen, K.D., Kronborg, C., Gyrd-Hansen, D., Dahl, R., Larsen, J.N., Lowenstein, H.: Quality of life in rhinoconjunctivitis assessed with generic and disease-specific questionnaires. Allergy 63(3), 284–291 (2008)CrossRef
3.
4.
go back to reference Bousquet, J., Khaltaev, N., Cruz, A.A., Denburg, J., Fokkens, W.J., Togias, A., Zuberbier, T., Baena-Cagnani, C.E., Canonica, G.W., van Weel, C., Agache, I., Ait-Khaled, N., Bachert, C., Blaiss, M.S., Bonini, S., Boulet, L.P., Bousquet, P.J., Camargos, P., Carlsen, K.H., Chen, Y., Custovic, A., Dahl, R., Demoly, P., Douagui, H., Durham, S.R., van Wijk, R.G., Kalayci, O., Kaliner, M.A., Kim, Y.Y., Kowalski, M.L., Kuna, P., Le, L.T., Lemiere, C., Li, J., Lockey, R.F., Mavale-Manuel, S., Meltzer, E.O., Mohammad, Y., Mullol, J., Naclerio, R., O’Hehir, R.E., Ohta, K., Ouedraogo, S., Palkonen, S., Papadopoulos, N., Passalacqua, G., Pawankar, R., Popov, T.A., Rabe, K.F., Rosado-Pinto, J., Scadding, G.K., Simons, F.E., Toskala, E., Valovirta, E., van Cauwenberge, P., Wang, D.Y., Wickman, M., Yawn, B.P., Yorgancioglu, A., Yusuf, O.M., Zar, H., Annesi-Maesano, I., Bateman, E.D., Ben Kheder, A., Boakye, D.A., Bouchard, J., Burney, P., Busse, W.W., Chan-Yeung, M., Chavannes, N.H., Chuchalin, A., Dolen, W.K., Emuzyte, R., Grouse, L., Humbert, M., Jackson, C., Johnston, S.L., Keith, P.K., Kemp, J.P., Klossek, J.M., Larenas-Linnemann, D., Lipworth, B., Malo, J.L., Marshall, G.D., Naspitz, C., Nekam, K., Niggemann, B., Nizankowska-Mogilnicka, E., Okamoto, Y., Orru, M.P., Potter, P., Price, D., Stoloff, S.W., Vandenplas, O., Viegi, G., Williams, D.: Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 86, 8–160 (2008)CrossRef Bousquet, J., Khaltaev, N., Cruz, A.A., Denburg, J., Fokkens, W.J., Togias, A., Zuberbier, T., Baena-Cagnani, C.E., Canonica, G.W., van Weel, C., Agache, I., Ait-Khaled, N., Bachert, C., Blaiss, M.S., Bonini, S., Boulet, L.P., Bousquet, P.J., Camargos, P., Carlsen, K.H., Chen, Y., Custovic, A., Dahl, R., Demoly, P., Douagui, H., Durham, S.R., van Wijk, R.G., Kalayci, O., Kaliner, M.A., Kim, Y.Y., Kowalski, M.L., Kuna, P., Le, L.T., Lemiere, C., Li, J., Lockey, R.F., Mavale-Manuel, S., Meltzer, E.O., Mohammad, Y., Mullol, J., Naclerio, R., O’Hehir, R.E., Ohta, K., Ouedraogo, S., Palkonen, S., Papadopoulos, N., Passalacqua, G., Pawankar, R., Popov, T.A., Rabe, K.F., Rosado-Pinto, J., Scadding, G.K., Simons, F.E., Toskala, E., Valovirta, E., van Cauwenberge, P., Wang, D.Y., Wickman, M., Yawn, B.P., Yorgancioglu, A., Yusuf, O.M., Zar, H., Annesi-Maesano, I., Bateman, E.D., Ben Kheder, A., Boakye, D.A., Bouchard, J., Burney, P., Busse, W.W., Chan-Yeung, M., Chavannes, N.H., Chuchalin, A., Dolen, W.K., Emuzyte, R., Grouse, L., Humbert, M., Jackson, C., Johnston, S.L., Keith, P.K., Kemp, J.P., Klossek, J.M., Larenas-Linnemann, D., Lipworth, B., Malo, J.L., Marshall, G.D., Naspitz, C., Nekam, K., Niggemann, B., Nizankowska-Mogilnicka, E., Okamoto, Y., Orru, M.P., Potter, P., Price, D., Stoloff, S.W., Vandenplas, O., Viegi, G., Williams, D.: Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 86, 8–160 (2008)CrossRef
5.
go back to reference Jarvis, D., Newson, R., Lotvall, J., Hastan, D., Tomassen, P., Keil, T., Gjomarkaj, M., Forsberg, B., Gunnbjornsdottir, M., Minov, J., Brozek, G., Dahlen, S.E., Toskala, E., Kowalski, M.L., Olze, H., Howarth, P., Kramer, U., Baelum, J., Loureiro, C., Kasper, L., Bousquet, P.J., Bousquet, J., Bachert, C., Fokkens, W., Burney, P.: Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe. Allergy 67(1), 91–98 (2012). https://doi.org/10.1111/j.1398-9995.2011.02709.x CrossRef Jarvis, D., Newson, R., Lotvall, J., Hastan, D., Tomassen, P., Keil, T., Gjomarkaj, M., Forsberg, B., Gunnbjornsdottir, M., Minov, J., Brozek, G., Dahlen, S.E., Toskala, E., Kowalski, M.L., Olze, H., Howarth, P., Kramer, U., Baelum, J., Loureiro, C., Kasper, L., Bousquet, P.J., Bousquet, J., Bachert, C., Fokkens, W., Burney, P.: Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe. Allergy 67(1), 91–98 (2012). https://​doi.​org/​10.​1111/​j.​1398-9995.​2011.​02709.​x CrossRef
6.
go back to reference Calderon, M.A., Gerth van Wijk, R., Eichler, I., Matricardi, P.M., Varga, E.M., Kopp, M.V., Eng, P., Niggemann, B., Nieto, A., Valovirta, E., Eigenmann, P.A., Pajno, G., Bufe, A., Halken, S., Beyer, K., Wahn, U.: European Academy of, A., Clinical, I.: Perspectives on allergen-specific immunotherapy in childhood: an EAACI position statement. Pediatr. Allergy Immunol. 23(4), 300–306 (2012). https://doi.org/10.1111/j.1399-3038.2012.01313.x CrossRefPubMed Calderon, M.A., Gerth van Wijk, R., Eichler, I., Matricardi, P.M., Varga, E.M., Kopp, M.V., Eng, P., Niggemann, B., Nieto, A., Valovirta, E., Eigenmann, P.A., Pajno, G., Bufe, A., Halken, S., Beyer, K., Wahn, U.: European Academy of, A., Clinical, I.: Perspectives on allergen-specific immunotherapy in childhood: an EAACI position statement. Pediatr. Allergy Immunol. 23(4), 300–306 (2012). https://​doi.​org/​10.​1111/​j.​1399-3038.​2012.​01313.​x CrossRefPubMed
7.
go back to reference Pfaar, O., Bachert, C., Bufe, A., Buhl, R., Ebner, C., Eng, P., Friedrichs, F., Fuchs, T., Hamelmann, E., Hartwig-Bade, D., Hering, T., Huttegger, I., Jung, K., Klimek, L., Kopp, M.V., Merk, H., Rabe, U., Saloga, J., Schmid-Grendelmeier, P., Schuster, A., Schwerk, N., Sitter, H., Umpfenbach, U., Wedi, B., Wöhrl, S., Worm, M., Kleine-Tebbe, J., Kaul, S., Schwalfenberg, A.: Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2 k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD). Allergo J. Int. 23(8), 282–319 (2014)CrossRef Pfaar, O., Bachert, C., Bufe, A., Buhl, R., Ebner, C., Eng, P., Friedrichs, F., Fuchs, T., Hamelmann, E., Hartwig-Bade, D., Hering, T., Huttegger, I., Jung, K., Klimek, L., Kopp, M.V., Merk, H., Rabe, U., Saloga, J., Schmid-Grendelmeier, P., Schuster, A., Schwerk, N., Sitter, H., Umpfenbach, U., Wedi, B., Wöhrl, S., Worm, M., Kleine-Tebbe, J., Kaul, S., Schwalfenberg, A.: Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2 k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD). Allergo J. Int. 23(8), 282–319 (2014)CrossRef
8.
go back to reference Dhami, S., Kakourou, A., Asamoah, F., Agache, I., Lau, S., Jutel, M., Muraro, A., Roberts, G., Akdis, C.A., Bonini, M., Cavkaytar, O., Flood, B., Gajdanowicz, P., Izuhara, K., Kalayci, O., Mosges, R., Palomares, O., Pfaar, O., Smolinska, S., Sokolowska, M., Asaria, M., Netuveli, G., Zaman, H., Akhlaq, A., Sheikh, A.: Allergen immunotherapy for allergic asthma: a systematic review and meta-analysis. Allergy 72(12), 1825–1848 (2017). https://doi.org/10.1111/all.13208 CrossRefPubMed Dhami, S., Kakourou, A., Asamoah, F., Agache, I., Lau, S., Jutel, M., Muraro, A., Roberts, G., Akdis, C.A., Bonini, M., Cavkaytar, O., Flood, B., Gajdanowicz, P., Izuhara, K., Kalayci, O., Mosges, R., Palomares, O., Pfaar, O., Smolinska, S., Sokolowska, M., Asaria, M., Netuveli, G., Zaman, H., Akhlaq, A., Sheikh, A.: Allergen immunotherapy for allergic asthma: a systematic review and meta-analysis. Allergy 72(12), 1825–1848 (2017). https://​doi.​org/​10.​1111/​all.​13208 CrossRefPubMed
9.
go back to reference Dhami, S., Nurmatov, U., Arasi, S., Khan, T., Asaria, M., Zaman, H., Agarwal, A., Netuveli, G., Roberts, G., Pfaar, O., Muraro, A., Ansotegui, I.J., Calderon, M., Cingi, C., Durham, S., van Wijk, R.G., Halken, S., Hamelmann, E., Hellings, P., Jacobsen, L., Knol, E., Larenas-Linnemann, D., Lin, S., Maggina, P., Mosges, R., Oude Elberink, H., Pajno, G., Panwankar, R., Pastorello, E., Penagos, M., Pitsios, C., Rotiroti, G., Timmermans, F., Tsilochristou, O., Varga, E.M., Schmidt-Weber, C., Wilkinson, J., Williams, A., Worm, M., Zhang, L., Sheikh, A.: Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis. Allergy 72(11), 1597–1631 (2017). https://doi.org/10.1111/all.13201 CrossRefPubMed Dhami, S., Nurmatov, U., Arasi, S., Khan, T., Asaria, M., Zaman, H., Agarwal, A., Netuveli, G., Roberts, G., Pfaar, O., Muraro, A., Ansotegui, I.J., Calderon, M., Cingi, C., Durham, S., van Wijk, R.G., Halken, S., Hamelmann, E., Hellings, P., Jacobsen, L., Knol, E., Larenas-Linnemann, D., Lin, S., Maggina, P., Mosges, R., Oude Elberink, H., Pajno, G., Panwankar, R., Pastorello, E., Penagos, M., Pitsios, C., Rotiroti, G., Timmermans, F., Tsilochristou, O., Varga, E.M., Schmidt-Weber, C., Wilkinson, J., Williams, A., Worm, M., Zhang, L., Sheikh, A.: Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis. Allergy 72(11), 1597–1631 (2017). https://​doi.​org/​10.​1111/​all.​13201 CrossRefPubMed
11.
go back to reference Reinhold, T., Lindig, C., Willich, S.N., Brüggenjürgen, B.: Patient characteristics in German allergological practices—a nationwide survey. Allergologie 34(5), 237–247 (2011)CrossRef Reinhold, T., Lindig, C., Willich, S.N., Brüggenjürgen, B.: Patient characteristics in German allergological practices—a nationwide survey. Allergologie 34(5), 237–247 (2011)CrossRef
12.
go back to reference Weschenfelder, A.-K., Wasem, J., Biermann, J.: Versorgung von Patienten mit allergischer Rhinitis—eine Analyse von Routinedaten einer gesetzlichen Krankenversicherung. Allergologie 38(5), 252–259 (2015)CrossRef Weschenfelder, A.-K., Wasem, J., Biermann, J.: Versorgung von Patienten mit allergischer Rhinitis—eine Analyse von Routinedaten einer gesetzlichen Krankenversicherung. Allergologie 38(5), 252–259 (2015)CrossRef
16.
go back to reference Hankin, C.S., Cox, L., Bronstone, A.: The health economics of allergen immunotherapy. Immunol. Allergy Clin. North Am. 31(2), 325–341 (2011)CrossRef Hankin, C.S., Cox, L., Bronstone, A.: The health economics of allergen immunotherapy. Immunol. Allergy Clin. North Am. 31(2), 325–341 (2011)CrossRef
17.
go back to reference Reinhold, T., Willich, S., Brüggenjürgen, B.: Subcutaneous specific immunotherapy: economic implications from the perspective of statutory health insurance—a population-based cost-effectiveness estimation. Allergologie 35(11), 539–550 (2012). https://doi.org/10.5414/alx01507 CrossRef Reinhold, T., Willich, S., Brüggenjürgen, B.: Subcutaneous specific immunotherapy: economic implications from the perspective of statutory health insurance—a population-based cost-effectiveness estimation. Allergologie 35(11), 539–550 (2012). https://​doi.​org/​10.​5414/​alx01507 CrossRef
25.
go back to reference Schmitz, R., Thamm, M., Ellert, U., Kalcklösch, M., Schlaud, M.: KiGGS Study Group: verbreitung häufiger Allergien bei Kindern und Jugendlichen in Deutschland. Ergebnisse der KiGGS-Studie—Erste Folgebefragung (KiGGS Welle 1). Bundesgesundheitsblatt—Gesundheitsforschung—Gesundheitsschutz 57(7), 771–778 (2014). https://doi.org/10.1007/s00103-014-1975-7 CrossRefPubMed Schmitz, R., Thamm, M., Ellert, U., Kalcklösch, M., Schlaud, M.: KiGGS Study Group: verbreitung häufiger Allergien bei Kindern und Jugendlichen in Deutschland. Ergebnisse der KiGGS-Studie—Erste Folgebefragung (KiGGS Welle 1). Bundesgesundheitsblatt—Gesundheitsforschung—Gesundheitsschutz 57(7), 771–778 (2014). https://​doi.​org/​10.​1007/​s00103-014-1975-7 CrossRefPubMed
30.
go back to reference Jacobsen, L., Niggemann, B., Dreborg, S., Ferdousi, H.A., Halken, S., Host, A., Koivikko, A., Norberg, L.A., Valovirta, E., Wahn, U., Moller, C.: Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy 62(8), 943–948 (2007)CrossRef Jacobsen, L., Niggemann, B., Dreborg, S., Ferdousi, H.A., Halken, S., Host, A., Koivikko, A., Norberg, L.A., Valovirta, E., Wahn, U., Moller, C.: Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy 62(8), 943–948 (2007)CrossRef
31.
go back to reference Mosbech, H., Osterballe, O.: Does the effect of immunotherapy last after termination of treatment? Follow-up study in patients with grass pollen rhinitis. Allergy 43(7), 523–529 (1988)CrossRef Mosbech, H., Osterballe, O.: Does the effect of immunotherapy last after termination of treatment? Follow-up study in patients with grass pollen rhinitis. Allergy 43(7), 523–529 (1988)CrossRef
32.
go back to reference Bock, J.O., Brettschneider, C., Seidl, H., Bowles, D., Holle, R., Greiner, W., Konig, H.H.: Calculation of standardised unit costs from a societal perspective for health economic evaluation. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) 77(1), 53–61 (2015). https://doi.org/10.1055/s-0034-1374621 CrossRef Bock, J.O., Brettschneider, C., Seidl, H., Bowles, D., Holle, R., Greiner, W., Konig, H.H.: Calculation of standardised unit costs from a societal perspective for health economic evaluation. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) 77(1), 53–61 (2015). https://​doi.​org/​10.​1055/​s-0034-1374621 CrossRef
33.
go back to reference Blumberga, G., Groes, L., Haugaard, L., Dahl, R.: Steroid-sparing effect of subcutaneous SQ-standardised specific immunotherapy in moderate and severe house dust mite allergic asthmatics. Allergy 61(7), 843–848 (2006)CrossRef Blumberga, G., Groes, L., Haugaard, L., Dahl, R.: Steroid-sparing effect of subcutaneous SQ-standardised specific immunotherapy in moderate and severe house dust mite allergic asthmatics. Allergy 61(7), 843–848 (2006)CrossRef
41.
go back to reference Thomas, M., Kocevar, V.S., Zhang, Q., Yin, D.D., Price, D.: Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis. Pediatrics 115(1), 129–134 (2005)CrossRef Thomas, M., Kocevar, V.S., Zhang, Q., Yin, D.D., Price, D.: Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis. Pediatrics 115(1), 129–134 (2005)CrossRef
42.
go back to reference Valovirta, E., Myrseth, S.E., Palkonen, S.: The voice of the patients: allergic rhinitis is not a trivial disease. Curr. Opin. Allergy Clin. Immunol. 8(1), 1–9 (2008)CrossRef Valovirta, E., Myrseth, S.E., Palkonen, S.: The voice of the patients: allergic rhinitis is not a trivial disease. Curr. Opin. Allergy Clin. Immunol. 8(1), 1–9 (2008)CrossRef
43.
go back to reference Halpern, M.T., Schmier, J.K., Richner, R., Guo, C., Togias, A.: Allergic rhinitis: a potential cause of increased asthma medication use, costs, and morbidity. J. Asthma 41(1), 117–126 (2004)CrossRef Halpern, M.T., Schmier, J.K., Richner, R., Guo, C., Togias, A.: Allergic rhinitis: a potential cause of increased asthma medication use, costs, and morbidity. J. Asthma 41(1), 117–126 (2004)CrossRef
51.
go back to reference Zawinell, A., Schwabe, U.: Antiallergika. In: Schwabe, U., Paffrath, D. (eds.) Arzneiverordnungs-Report 2016, pp. 251–271. Springer-Verlag, Berlin (2016)CrossRef Zawinell, A., Schwabe, U.: Antiallergika. In: Schwabe, U., Paffrath, D. (eds.) Arzneiverordnungs-Report 2016, pp. 251–271. Springer-Verlag, Berlin (2016)CrossRef
52.
go back to reference Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G., Rak, S., Emminger, W., Rivas, M.F., Ribel, M., Durham, S.R., Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G.R., Rak, S., Emminger, W., Rivas, M.F., Ribel, M., Durham, S.R.: Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinoconjunctivitis. J. Allergy Clin. Immunol. 118(2), 434–440 (2006)CrossRef Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G., Rak, S., Emminger, W., Rivas, M.F., Ribel, M., Durham, S.R., Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G.R., Rak, S., Emminger, W., Rivas, M.F., Ribel, M., Durham, S.R.: Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinoconjunctivitis. J. Allergy Clin. Immunol. 118(2), 434–440 (2006)CrossRef
53.
go back to reference Canonica, G.W., Bousquet, J., Mullol, J., Scadding, G.K., Virchow, J.C.: A survey of the burden of allergic rhinitis in Europe. Allergy 62(Suppl 85), 17–25 (2007)CrossRef Canonica, G.W., Bousquet, J., Mullol, J., Scadding, G.K., Virchow, J.C.: A survey of the burden of allergic rhinitis in Europe. Allergy 62(Suppl 85), 17–25 (2007)CrossRef
54.
go back to reference Lamb, C.E., Ratner, P.H., Johnson, C.E., Ambegaonkar, A.J., Joshi, A.V., Day, D., Sampson, N., Eng, B.: Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr. Med. Res. Opin. 22(6), 1203–1210 (2006)CrossRef Lamb, C.E., Ratner, P.H., Johnson, C.E., Ambegaonkar, A.J., Joshi, A.V., Day, D., Sampson, N., Eng, B.: Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr. Med. Res. Opin. 22(6), 1203–1210 (2006)CrossRef
55.
go back to reference Nasser, S., Vestenbaek, U., Beriot-Mathiot, A., Poulsen, P.B.: Cost-effectiveness of specific immunotherapy with Grazax in allergic rhinitis co-existing with asthma. Allergy 63(12), 1624–1629 (2008)CrossRef Nasser, S., Vestenbaek, U., Beriot-Mathiot, A., Poulsen, P.B.: Cost-effectiveness of specific immunotherapy with Grazax in allergic rhinitis co-existing with asthma. Allergy 63(12), 1624–1629 (2008)CrossRef
56.
go back to reference Sadatsafavi, M., Rousseau, R., Chen, W., Zhang, W., Lynd, L., FitzGerald, J.M.: Economic Burden of Asthma Study, T.: the preventable burden of productivity loss due to suboptimal asthma control: a population-based study. Chest 145(4), 787–793 (2014)CrossRef Sadatsafavi, M., Rousseau, R., Chen, W., Zhang, W., Lynd, L., FitzGerald, J.M.: Economic Burden of Asthma Study, T.: the preventable burden of productivity loss due to suboptimal asthma control: a population-based study. Chest 145(4), 787–793 (2014)CrossRef
61.
go back to reference McCallister, J.W., Holbrook, J.T., Wei, C.Y., Parsons, J.P., Benninger, C.G., Dixon, A.E., Gerald, L.B., Mastronarde, J.G.: Sex differences in asthma symptom profiles and control in the American Lung association asthma clinical research centers. Respir. Med. 107(10), 1491–1500 (2013)CrossRef McCallister, J.W., Holbrook, J.T., Wei, C.Y., Parsons, J.P., Benninger, C.G., Dixon, A.E., Gerald, L.B., Mastronarde, J.G.: Sex differences in asthma symptom profiles and control in the American Lung association asthma clinical research centers. Respir. Med. 107(10), 1491–1500 (2013)CrossRef
63.
go back to reference Revicki, D.A., Leidy, N.K., Brennan-Diemer, F., Thompson, C., Togias, A.: Development and preliminary validation of the multiattribute Rhinitis Symptom Utility Index. Qual. Life Res. 7(8), 693–702 (1998)CrossRef Revicki, D.A., Leidy, N.K., Brennan-Diemer, F., Thompson, C., Togias, A.: Development and preliminary validation of the multiattribute Rhinitis Symptom Utility Index. Qual. Life Res. 7(8), 693–702 (1998)CrossRef
64.
go back to reference Tamayama, K., Kondo, M., Shono, A., Okubo, I.: Utility weights for allergic rhinitis based on a community surgery with a time trade-off technique in Japan. Allergol 58(2), 201–207 (2009)CrossRef Tamayama, K., Kondo, M., Shono, A., Okubo, I.: Utility weights for allergic rhinitis based on a community surgery with a time trade-off technique in Japan. Allergol 58(2), 201–207 (2009)CrossRef
65.
go back to reference Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G., Rak, S., Emminger, W., Riis, B., Gronager, P.M., Durham, S.R., Dahl, R., Kapp, A., Colombo, G., Rak, S., Emminger, W., Riis, B., Gronager, P.M., Durham, S.R.: Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J. Allergy Clin. Immunol. 121(2), 512–518.e512 (2008)CrossRef Dahl, R., Kapp, A., Colombo, G., de Monchy, J.G., Rak, S., Emminger, W., Riis, B., Gronager, P.M., Durham, S.R., Dahl, R., Kapp, A., Colombo, G., Rak, S., Emminger, W., Riis, B., Gronager, P.M., Durham, S.R.: Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J. Allergy Clin. Immunol. 121(2), 512–518.e512 (2008)CrossRef
66.
go back to reference De Vos, C., Mitchev, K., Pinelli, M.-E., Derde, M.-P., Boev, R.: Non-interventional study comparing treatment satisfaction in patients treated with antihistamines. Clin. Drug Investig. 28(4), 221–230 (2008)CrossRef De Vos, C., Mitchev, K., Pinelli, M.-E., Derde, M.-P., Boev, R.: Non-interventional study comparing treatment satisfaction in patients treated with antihistamines. Clin. Drug Investig. 28(4), 221–230 (2008)CrossRef
67.
go back to reference Schatz, M.: A survey of the burden of allergic rhinitis in the USA. Allergy: european. J. Allergy Clin. Immunol. 62(SUPPL. 85), 9–16 (2007)CrossRef Schatz, M.: A survey of the burden of allergic rhinitis in the USA. Allergy: european. J. Allergy Clin. Immunol. 62(SUPPL. 85), 9–16 (2007)CrossRef
68.
go back to reference Bachert, C., Vestenbaek, U., Christensen, J., Griffiths, U.K., Poulsen, P.B.: Cost-effectiveness of grass allergen tablet (GRAZAX) for the prevention of seasonal grass pollen induced rhinoconjunctivitis—a Northern European perspective. Clin. Exp. Allergy 37(5), 772–779 (2007)CrossRef Bachert, C., Vestenbaek, U., Christensen, J., Griffiths, U.K., Poulsen, P.B.: Cost-effectiveness of grass allergen tablet (GRAZAX) for the prevention of seasonal grass pollen induced rhinoconjunctivitis—a Northern European perspective. Clin. Exp. Allergy 37(5), 772–779 (2007)CrossRef
70.
go back to reference Juniper, E.F., Guyatt, G.H.: Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin. Exp. Allergy 21(1), 77–83 (1991)CrossRef Juniper, E.F., Guyatt, G.H.: Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin. Exp. Allergy 21(1), 77–83 (1991)CrossRef
71.
go back to reference Juniper, E.F., Guyatt, G.H., Epstein, R.S., Ferrie, P.J., Jaeschke, R., Hiller, T.K.: Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. Thorax 47(2), 76–83 (1992)CrossRef Juniper, E.F., Guyatt, G.H., Epstein, R.S., Ferrie, P.J., Jaeschke, R., Hiller, T.K.: Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. Thorax 47(2), 76–83 (1992)CrossRef
72.
go back to reference Revicki, D.A., Leidy, N.K., Brennan-Diemer, F., Sorensen, S., Togias, A.: Integrating patient preferences into health outcomes assessment: the multiattribute Asthma Symptom Utility Index. Chest 114(4), 998–1007 (1998)CrossRef Revicki, D.A., Leidy, N.K., Brennan-Diemer, F., Sorensen, S., Togias, A.: Integrating patient preferences into health outcomes assessment: the multiattribute Asthma Symptom Utility Index. Chest 114(4), 998–1007 (1998)CrossRef
73.
go back to reference Klimek, L., Uhlig, J., Mösges, R., Rettig, K., Pfaar, O.: A high polymerized grass pollen extract is efficacious and safe in a randomized double-blind, placebo-controlled study using a novel up-dosing cluster-protocol. Allergy: Eur J. Allergy Clin. Immunol. 69(12), 1629–1638 (2014)CrossRef Klimek, L., Uhlig, J., Mösges, R., Rettig, K., Pfaar, O.: A high polymerized grass pollen extract is efficacious and safe in a randomized double-blind, placebo-controlled study using a novel up-dosing cluster-protocol. Allergy: Eur J. Allergy Clin. Immunol. 69(12), 1629–1638 (2014)CrossRef
74.
go back to reference Mussler, S., Kettner, J., Akboga, Y., Thum-Oltmer, S.: Efficacy of preseasonal high-dose hypoallergenic grass pollen SCIT in formerly placebo-treated patients in the open-label phase. Allergy: Eur. J. Allergy Clin. Immunol. 70, 375 (2015) ((Mussler S.; Kettner J.; Akboga Y.; Thum-Oltmer S.) Allergopharma GmbH and Co. KG, Reinbek, Germany) Mussler, S., Kettner, J., Akboga, Y., Thum-Oltmer, S.: Efficacy of preseasonal high-dose hypoallergenic grass pollen SCIT in formerly placebo-treated patients in the open-label phase. Allergy: Eur. J. Allergy Clin. Immunol. 70, 375 (2015) ((Mussler S.; Kettner J.; Akboga Y.; Thum-Oltmer S.) Allergopharma GmbH and Co. KG, Reinbek, Germany)
76.
go back to reference Schwarzer, R., Rochau, U., Saverno, K., Jahn, B., Bornschein, B., Muehlberger, N., Flatscher-Thoeni, M., Schnell-Inderst, P., Sroczynski, G., Lackner, M., Schall, I., Hebborn, A., Pugner, K., Fehervary, A., Brixner, D., Siebert, U.: Systematic overview of cost-effectiveness thresholds in ten countries across four continents. J. Comp Eff Res. 4(5), 485–504 (2015). https://doi.org/10.2217/cer.15.38 CrossRefPubMed Schwarzer, R., Rochau, U., Saverno, K., Jahn, B., Bornschein, B., Muehlberger, N., Flatscher-Thoeni, M., Schnell-Inderst, P., Sroczynski, G., Lackner, M., Schall, I., Hebborn, A., Pugner, K., Fehervary, A., Brixner, D., Siebert, U.: Systematic overview of cost-effectiveness thresholds in ten countries across four continents. J. Comp Eff Res. 4(5), 485–504 (2015). https://​doi.​org/​10.​2217/​cer.​15.​38 CrossRefPubMed
82.
go back to reference National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung KVB): Onlie Version of the Uniform Value Scale (Online Version des Einheitlichen Bewertungsmaßstab EBM). http://www.kbv.de/html/online-ebm.php (2017). Accessed 12 March 2017 National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung KVB): Onlie Version of the Uniform Value Scale (Online Version des Einheitlichen Bewertungsmaßstab EBM). http://​www.​kbv.​de/​html/​online-ebm.​php (2017). Accessed 12 March 2017
Metadata
Title
Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach
Authors
Ann-Kathrin Richter
Ludger Klimek
Hans F. Merk
Norbert Mülleneisen
Harald Renz
Wolfgang Wehrmann
Thomas Werfel
Eckard Hamelmann
Uwe Siebert
Gaby Sroczynski
Jürgen Wasem
Janine Biermann-Stallwitz
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 9/2018
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-018-0970-6

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