Cost-Effectiveness Of The SQ® Grass SLIT-Tablet In Children With Allergic Rhinitis: A German Payer Perspective

Abstract

Christian Vogelberg,1 Eckard Hamelmann,2 Ulrich Wahn,3 Anne Domdey,4 Richard F Pollock,5 Tobias S Grand4 1Technische Universität Dresden, Dresden, Germany; 2Klinik Für Kinder- und Jugendmedizin, Evangelisches Klinikum Bethel GmbH, Akademisches Lehrkrankenhaus der Universität Münster, Bielefeld, Germany; 3Klinik Für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité, Berlin, Germany; 4ALK-Abelló A/S, Hørsholm, Denmark; 5Covalence Research Ltd, London, UKCorrespondence: Tobias S GrandALK-Abelló A/S, Hørsholm, DenmarkTel [phone]Email [email protected]: The Grazax Asthma Prevention (GAP) trial has recently demonstrated significant reductions in the odds of asthma symptoms or medication use in patients treated with SQ® grass SLIT-tablet relative to placebo, both in combination with allergy and asthma pharmacotherapy. The objective of the present analysis was to evaluate the cost-effectiveness of SQ grass SLIT-tablet relative to placebo in children with AR from the perspective of a German healthcare payer.Methods: A cost-utility model was developed in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) to evaluate the cost-utility of SQ grass SLIT-tablet in combination with pharmacotherapy versus pharmacotherapy alone in patients with AR. Transition probabilities were derived from the GAP trial, and costs were taken from a real-world insurance database analysis. Future costs and effects were discounted at 3% per annum, and extensive deterministic and probabilistic sensitivity analyses were performed.Results: Over a 10-year time horizon, the base case analysis showed an increase in overall treatment costs of €897 per child being treated with SQ grass SLIT-tablet relative to pharmacotherapy alone. The increased treatment costs were accompanied by an improvement in patient quality of life of 0.10 quality-adjusted life years (QALYs) yielding an ICER of €8978 per QALY gained, falling well below a willingness-to-pay threshold of €17,800 per QALY gained. The base case results were insensitive to changes in all individual model parameters.Discussion: Improvements in quality of life with the SQ grass SLIT-tablet would be accompanied by only a modest increase in costs over a 10-year time horizon, with the SQ grass SLIT-tablet therefore representing excellent value for money from the German healthcare payer perspective.Keywords: rhinitis, allergic, asthma, costs and cost analysis, Germany  

Keywords

• rhinitis
• allergic
• asthma
• costs and cost analysis
• germany