TY - JOUR
T1 - Economic Evaluation of 5-Grass Pollen Tablets Versus Placebo in the Treatment of Allergic Rhinitis in Adults
AU - Ruggeri, Matteo
AU - Oradei, Marco
AU - Frati, Franco
AU - Puccinelli, Paola
AU - Romao, Cristina
AU - Dell'Albani, Ilaria
AU - Incorvaia, Cristoforo
PY - 2013
Y1 - 2013
N2 - Background Allergen immunotherapy (AIT) is aimed at
modifying the immune response to a causative allergen,
thereby reducing clinical symptoms and symptomatic
medication intake and improving quality of life. Long-term
AIT research has led to the development of 5-grass pollen
tablets, currently indicated for the treatment of grass polleninduced
allergic rhinitis (AR).
Methods A post-hoc analysis was conducted using the
Average Adjusted Symptom Score (AAdSS) to compare
the effect of treatment of AR with 5-grass pollen tablets
versus placebo treatment. Using the results of the VO34.04
and VO53.06 trials and economic data, cost-effectiveness
analysis of 5-grass pollen tablet treatment was performed
from the Italian third-party payer perspective with cost data
derived from a study of 2008 updated to 2011. Also a
societal perspective was considered by using the costs
related to the losses of productivity by following the human
capital approach. Using the results of the analysis, the
estimated receiver-operating characteristic curve was
plotted to evaluate medication effectiveness in terms of
quality-adjusted life years (QALYs) and a decision tree
constructed to model the possible outcomes and costs for
adults and paediatric patients with a low, medium, and high
AAdSS. Finally, probabilistic sensitivity analysis was
conducted to test the robustness of the results as well as
their consistency at an assumed cost-effectiveness threshold
of € 30,000/QALY.
Results The results indicate that compared to the placebo,
the 5-grass pollen tablet treatment provides a benefit of
0.127 QALYs in medium AAdSS patients and of 0.143
QALYs in high AAdSS patients. The 5-grass pollen tablet
treatment was found to cost € 1,024/QALY for patients
with a medium AAdSS and € 1,035/QALY for patients
with a high AAdSS. Of all the simulations performed in the
probabilistic sensitivity analysis, 99 % indicated that the
incremental cost-effectiveness ratio of the 5-grass pollen
tablet treatment was below the threshold of € 30,000/
QALY in patients with medium and high AAdSS, whereas
it was found to be dominated in 67 % of simulations
related to patients with low AAdSS.
Conclusion The 5-grass pollen tablet is a cost-effective
treatment for adult AR patients with a medium or high
AAdSS. This finding should be carefully considered when
deciding the management strategy for these patients.
AB - Background Allergen immunotherapy (AIT) is aimed at
modifying the immune response to a causative allergen,
thereby reducing clinical symptoms and symptomatic
medication intake and improving quality of life. Long-term
AIT research has led to the development of 5-grass pollen
tablets, currently indicated for the treatment of grass polleninduced
allergic rhinitis (AR).
Methods A post-hoc analysis was conducted using the
Average Adjusted Symptom Score (AAdSS) to compare
the effect of treatment of AR with 5-grass pollen tablets
versus placebo treatment. Using the results of the VO34.04
and VO53.06 trials and economic data, cost-effectiveness
analysis of 5-grass pollen tablet treatment was performed
from the Italian third-party payer perspective with cost data
derived from a study of 2008 updated to 2011. Also a
societal perspective was considered by using the costs
related to the losses of productivity by following the human
capital approach. Using the results of the analysis, the
estimated receiver-operating characteristic curve was
plotted to evaluate medication effectiveness in terms of
quality-adjusted life years (QALYs) and a decision tree
constructed to model the possible outcomes and costs for
adults and paediatric patients with a low, medium, and high
AAdSS. Finally, probabilistic sensitivity analysis was
conducted to test the robustness of the results as well as
their consistency at an assumed cost-effectiveness threshold
of € 30,000/QALY.
Results The results indicate that compared to the placebo,
the 5-grass pollen tablet treatment provides a benefit of
0.127 QALYs in medium AAdSS patients and of 0.143
QALYs in high AAdSS patients. The 5-grass pollen tablet
treatment was found to cost € 1,024/QALY for patients
with a medium AAdSS and € 1,035/QALY for patients
with a high AAdSS. Of all the simulations performed in the
probabilistic sensitivity analysis, 99 % indicated that the
incremental cost-effectiveness ratio of the 5-grass pollen
tablet treatment was below the threshold of € 30,000/
QALY in patients with medium and high AAdSS, whereas
it was found to be dominated in 67 % of simulations
related to patients with low AAdSS.
Conclusion The 5-grass pollen tablet is a cost-effective
treatment for adult AR patients with a medium or high
AAdSS. This finding should be carefully considered when
deciding the management strategy for these patients.
KW - COST EFFECTIVENESS
KW - COST EFFECTIVENESS
UR - http://hdl.handle.net/10807/51963
M3 - Article
VL - 3
SP - 343
EP - 349
JO - Clinical Drug Investigation
JF - Clinical Drug Investigation
SN - 1173-2563
ER -