| Title |
Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach
|
|---|---|
| Published in |
HEPAC Health Economics in Prevention and Care, March 2018
|
| DOI | 10.1007/s10198-018-0970-6 |
| Pubmed ID | |
| Authors |
Ann-Kathrin Richter, Ludger Klimek, Hans F. Merk, Norbert Mülleneisen, Harald Renz, Wolfgang Wehrmann, Thomas Werfel, Eckard Hamelmann, Uwe Siebert, Gaby Sroczynski, Jürgen Wasem, Janine Biermann-Stallwitz |
| Abstract |
Specific immunotherapy is the only causal treatment in respiratory allergy. Due to high treatment cost and possible severe side effects subcutaneous immunotherapy (SCIT) is not indicated in all patients. Nevertheless, reported treatment rates seem to be low. This study aims to analyze the effects of increasing treatment rates of SCIT in respiratory allergy in terms of costs and quality-adjusted life years (QALYs). A state-transition Markov model simulates the course of disease of patients with allergic rhinitis, allergic asthma and both diseases over 10 years including a symptom-free state and death. Treatment comprises symptomatic pharmacotherapy alone or combined with SCIT. The model compares two strategies of increased and status quo treatment rates. Transition probabilities are based on routine data. Costs are calculated from the societal perspective applying German unit costs to literature-derived resource consumption. QALYs are determined by translating the mean change in non-preference-based quality of life scores to a change in utility. Key parameters are subjected to deterministic sensitivity analyses. Increasing treatment rates is a cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of 3484€/QALY compared to the status quo. The most influential parameters are SCIT discontinuation rates, treatment effects on the transition probabilities and cost of SCIT. Across all parameter variations, the best case leads to dominance of increased treatment rates while the worst case ICER is 34,315€/QALY. Excluding indirect cost leads to a twofold increase in the ICER. Measures to increase SCIT initiation rates should be implemented and also address improving adherence. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Professor | 4 | 12% |
| Student > Bachelor | 4 | 12% |
| Student > Master | 3 | 9% |
| Student > Ph. D. Student | 3 | 9% |
| Other | 2 | 6% |
| Other | 7 | 21% |
| Unknown | 11 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 26% |
| Economics, Econometrics and Finance | 2 | 6% |
| Nursing and Health Professions | 2 | 6% |
| Social Sciences | 2 | 6% |
| Decision Sciences | 2 | 6% |
| Other | 5 | 15% |
| Unknown | 12 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 March 2018.
All research outputs
#17,292,294
of 25,382,440 outputs
Outputs from HEPAC Health Economics in Prevention and Care
#919
of 1,303 outputs
Outputs of similar age
#223,737
of 346,643 outputs
Outputs of similar age from HEPAC Health Economics in Prevention and Care
#16
of 26 outputs
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