Cost-effectiveness of GRAZAX((R)) for prevention of grass pollen induced rhinoconjunctivitis in Southern Europe

Università degli Studi di Genova, Genova, Liguria, Italy
Respiratory Medicine (Impact Factor: 3.09). 10/2007; 101(9):1885-94. DOI: 10.1016/j.rmed.2007.05.003
Source: PubMed


Allergic rhinoconjunctivitis is a global health problem. Around 14 million people in Spain, France, Italy, and Austria suffer from grass pollen induced allergic rhinitis. Standard care only provides symptoms relief, while allergen specific immunotherapy (SIT) treats the underlying cause of the disease. Grazax from ALK-Abelló is a new, tablet-based, effective route of SIT for home treatment. The objective was to assess the cost-effectiveness of Grazax in four Southern European countries.
A prospective pharmacoeconomic analyses was carried out alongside a multinational, clinical trial measuring the efficacy of Grazax. Pooled data on resource use and health outcomes were collected. A societal perspective was adopted, and the analysis had a nine-year time horizon. The primary outcome measure was quality adjusted life years (QALYs).
Grazax was superior to standard care for all efficacy endpoints, including QALYs gained, and resulted in significantly less use of rescue medication and fewer hours missed from work. Grazax was cost-effective for all countries for an annual price in the range of 1500 euros - 1900 euros. The result was improved by inclusion of future costs of asthma and exclusion of Spanish trial centers which experienced an exceptionally low pollen season.
The analysis illustrates that allergen SIT with Grazax for grass pollen induced rhinoconjunctivitis is a cost-effective intervention in Southern Europe.

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    • "Two other studies concerned the evaluation of economic aspects of SLIT performed using oral tablets for grass pollen allergen in northern [42] and southern Europe [43]. The aim of the first study was the assessment of cost-effectiveness of grass allergen tablets compared with the use of symptomatic drugs in 7 northern European countries. "
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    ABSTRACT: Specific immunotherapy is the only treatment able to act on the causes and not only on the symptoms of respiratory allergy. Sublingual immunotherapy (SLIT) was introduced as an option to subcutaneous immunotherapy (SCIT), the clinical effectiveness of which is partly counterbalanced by the issue of adverse systemic reactions, which occur at a frequency of about 0.2% of injections and 2-5% of the patients and may also be life-threatening. A large number of trials, globally evaluated by several meta-analyses, demonstrated that SLIT is an effective and safe treatment for allergic rhinitis and allergic asthma, severe reactions being extremely rare. The application of SLIT is favored by a good compliance, higher than that reported for SCIT, in which the injections are a major factor for noncompliance because of inconvenience, and by its cost-effectiveness. In fact, a number of studies showed that SLIT may be very beneficial to the healthcare system, especially when its effectiveness persists after treatment withdrawal because of the induced immunologic changes.
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    • "A formal cost-benefit analysis by a pharmacoeconomic model [33] showed that SLIT for pollinosis in patients with rhinitis and/or asthma leads to a significant saving (in terms of direct and indirect costs). The same was seen in the pharmacoeconomic analyses performed in the large grass-tablet studies [34,35]. "
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