Economic evaluation of sublingual immunotherapy vs symptomatic treatment in adults with pollen-induced respiratory allergy: the Sublingual Immunotherapy Pollen Allergy Italy (SPAI) study

被引:51
|
作者
Berto, Patrizia
Passalacqua, Giovanni
Crimi, Nunzio
Frati, Franco
Ortolani, Claudio
Senna, Gianenrico
Canonica, Giorgio Walter
机构
[1] Univ Genoa, Dept Internal Med, I-16132 Genoa, Italy
[2] Univ Padua, Sch Pharm, I-35100 Padua, Italy
[3] PBE Consulting, Verona, Italy
[4] Univ Catania, I-95124 Catania, Italy
[5] Univ Perugia, Dept Pediat, I-06100 Perugia, Italy
[6] Stallergenes, Dept Med, Milan, Italy
[7] Ist Allergol Lombardo, Milan, Italy
[8] Verona Gen Hosp, Allergy Serv, Verona, Italy
关键词
D O I
10.1016/S1081-1206(10)61090-3
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Few data are available on the pharmacoeconomic aspects of immunotherapy. Objective: To evaluate, from the health care system and societal perspectives, the costs and consequences of sublingual immunotherapy (SLIT) added to pharmacotherapy compared with drugs alone for respiratory allergy. Methods: This study compared costs, clinical outcomes, and cost-effectiveness ratios of 2 strategies in the management of allergic rhinitis and asthma, namely, SLIT associated with pharmacotherapy and pharmacotherapy alone (no SLIT). A decision tree was developed and populated with epidemiologic and resource utilization data concerning approximately 2,200 patients. Direct costs included visits, tests, pharmacotherapy, immunotherapy, and hospitalizations. Indirect costs and out-of-pocket drugs were also included. Outcome was calculated as the number of improved patients and asthma cases avoided at 6 years. Sensitivity analysis was performed by varying costs and epidemiologic data. Results: SLIT improved the symptoms of 399 of 1,000 patients and prevented asthma in 229 of 1,000 patients compared with drugs alone. For SLIT added to pharmacotherapy and pharmacotherapy alone, the direct cost per patient at more than 6 years was EURO2,400 and EURO3,026, whereas the indirect cost was EURO1,913 and EURO3,400. Conclusion: From both perspectives and for both effectiveness end points, SLIT is less expensive and more effective than pharmacotherapy alone.
引用
收藏
页码:615 / 621
页数:7
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