Keiding Hans, Jørgensen Kasper P
Department of Economics, University of Copenhagen, Copenhagen, Denmark.
Curr Med Res Opin. 2007 May;23(5):1113-20. doi: 10.1185/030079907x187865.
Seasonal allergic rhinoconjunctivitis can, for some people, reduce quality of life and the ability to cope with everyday tasks.
In this paper we investigate the cost-effectiveness of immunization therapy with Alutard SQ (ASQ) and compare the cost-effectiveness in countries where the therapy has been in use in order to assess the impact of national therapeutic practices on the results of health economic assessments. Data are obtained from a clinical trial carried out in 2001-2002. To evaluate the cost-effectiveness of immunization we have added data on resource use in Austria, Denmark, Finland, Germany, The Netherlands, and Sweden.
The computations result in cost-effectiveness ratios for allergen immunization between 10,000 euros and 20,000 euros per QALY even without provision for indirect costs, and achieving dominance in most countries where indirect costs have also been taken into account. The country comparisons show that the direct cost of administrating the up-dosing and maintenance differs considerably between countries, and that the cost of medical staff is substantial, constituting in most cases more than half of the direct costs of the immunization therapy.
The study shows that immunotherapy with SQ allergen extract is cost-effective in a wide range of national environments, and that cost-effectiveness differences by country are largely a result of different practices in the up-dosing phase.
对于一些人来说，季节性变应性鼻结膜炎会降低生活质量以及应对日常任务的能力。
在本文中，我们研究了Alutard SQ（ASQ）免疫疗法的成本效益，并比较了该疗法已投入使用的国家的成本效益，以评估国家治疗实践对卫生经济评估结果的影响。数据来自于2001 - 2002年进行的一项临床试验。为了评估免疫疗法的成本效益，我们补充了奥地利、丹麦、芬兰、德国、荷兰和瑞典的资源使用数据。
即使不考虑间接成本，计算得出的变应原免疫疗法的成本效益比为每获得一个质量调整生命年（QALY）10,000欧元至20,000欧元，并且在大多数也考虑了间接成本的国家中占据优势。国家间比较表明，各国在追加剂量和维持治疗的管理直接成本上存在很大差异，而且医务人员成本很高，在大多数情况下占免疫疗法直接成本的一半以上。
该研究表明，在广泛的国家环境中，使用SQ变应原提取物进行免疫疗法具有成本效益，并且各国之间成本效益的差异很大程度上是由于追加剂量阶段的不同做法所致。
