Influence of subcutaneous specific immunotherapy on drug costs in children sufferingfrom allergic asthma

Abstract

Background: Subcutaneous specific immunotherapy (SCIT) is an effective treatment attenuatingthe progression of allergic asthma. To date, there is a lack of studiesinvestigating the economic consequences of SCIT on health care expenditures. Methods: A health-economic piggy-back analysis of SCIT was conducted based on a RCT thatenrolled 65 children and adolescents with allergic asthma. Patients were allocatedinto two groups: A group receiving SCIT with a high-dose hypoallergenic house dustmite preparation plus asthma medication and a control group receiving only asthmamedication. For both groups asthma control was achieved before the start of theSCIT treatment and was maintained during the study. Both, costs andcost-effectiveness of SCIT with the high-dose hypoallergenic house dust mitepreparation were investigated based on total medication costs, incrementalmedication costs and treatment effects (measured as lung function), respectively.A bootstrap analysis was performed to validate the results. Results: A steady decline in medication costs could be observed in the SCIT group one yearafter treatment start compared to the control group. This cost trend becamestatistically significant 3 years after SCIT started. The calculated potentialsavings in the SCIT group correlated with an improved lung function. Thedistribution of the bootstrap results revealed that the probability of SCIT havinga superior effectiveness compared to the control group is around 90%. Conclusion: SCIT with a high-dose hypoallergenic preparation received by children andadolescents suffering from mite induced allergic asthma reduces the allergicmedication intake and has cost-saving effects. Additional costs associated withSCIT may be completely compensated by drug cost savings 4 years after end of SCIT.Additionally, SCIT is superior compared to routine care as measured by the lungfunction that improved in SCIT-treated patients. Trial registration: (EudraCT no.2004 - 003892 - 35).