Economic evaluation of SQ-standardized grass allergy immunotherapy tablet (Grazax®) in children

Abstract

Sarah Ronaldson,1 Matthew Taylor,1 Peter G Bech,2 Ruth Shenton,1 Albrecht Bufe3 1York Health Economics Consortium, York, UK; 2ALK-Abelló A/S, Hørsholm, Denmark; 3Ruhr-Universität Bochum, Bochum, Germany Background: Grass pollen-induced rhinoconjunctivitis is a common allergic respiratory disorder affecting over 20% of the UK population in terms of quality of life and sleep, work, and school patterns. The SQ-standardized grass allergy immunotherapy tablet (AIT) has been demonstrated as a disease-modifying treatment which gives a sustained effect even after completion of a treatment course. The objective of this study was to provide an economic assessment of whether treatment with the SQ-standardized grass AIT, Grazax® (Phleum pratense) in combination with symptomatic medications is preferable to the standard of care using symptomatic medications only. The analysis was performed for children with grass pollen-induced rhinoconjunctivitis, with or without concomitant asthma, in the UK. Methods: The model evaluated the two treatment regimens in a cohort of 1,000 children from a payer’s perspective. Treatment was modeled in terms of management of symptoms, impact on resource use, and development of allergic asthma. The analysis modeled the use of SQ-standardized grass AIT and the sustained effects of treatment over a 9-year time horizon (ie, 3 years of treatment, with modeled long-term benefits). Data inputs were drawn from a recent clinical trial, published studies, and databases. Results: SQ-standardized grass AIT improves patient outcomes, generating an incremental cost per quality-adjusted life year gained of £12,168. This is below commonly accepted thresholds in the UK. Conclusion: The resulting incremental cost per QALY falls below commonly accepted willingness to pay thresholds. Therefore, the SQ-standardized grass AIT is a cost-effective option for the treatment of grass pollen-induced rhinoconjunctivitis in the UK pediatric population. Keywords: cost-effectiveness, cost, quality of life, cost-benefit, United Kingdom, rhinoconjunctivitis, infant