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A Cost-Minimisation Analysis Comparing Sublingual Immunotherapy to Subcutaneous Immunotherapy for the Treatment of House Dust Mite Allergy in a Swedish Setting

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Abstract

Background and Objectives

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.

Conclusion

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.

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Author information

Authors and Affiliations

  1. Nordic Health Economics AB, Gothenburg, Sweden

    Åse Björstad

  2. Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Lars-Olaf Cardell

  3. Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden

    Lars-Olaf Cardell

  4. ALK, Hørsholm, Denmark

    Julie Hahn-Pedersen

  5. ALK, Kungsbacka, Sweden

    Mikael Svärd

Authors
  1. Åse Björstad
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  2. Lars-Olaf Cardell
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  3. Julie Hahn-Pedersen
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  4. Mikael Svärd
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Corresponding author

Correspondence to Åse Björstad.

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Funding

This study was funded by ALK Nordic A/S.

Conflicts of interest

Åse Björstad is employed by Nordic Health Economics AB, which received a fee for services related to the development and execution of this study, and for the analysis, and reporting of its results. Lars-Olaf Cardell has received grants, consulting honorariums, travel grants and an honorarium for his contributions to evaluating this study and to the development of this manuscript, all from ALK. Julie Hahn-Pedersen was an employee of ALK during development of this manuscript and has stock options in ALK. Mikael Svärd is employed by ALK.

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Björstad, Å., Cardell, LO., Hahn-Pedersen, J. et al. A Cost-Minimisation Analysis Comparing Sublingual Immunotherapy to Subcutaneous Immunotherapy for the Treatment of House Dust Mite Allergy in a Swedish Setting. Clin Drug Investig 37, 541–549 (2017). https://doi.org/10.1007/s40261-017-0516-1

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