Pollock Richard F, Slættanes Andreas K, Brandi Henrik, Grand Tobias Sydendal
Covalence Research Ltd, Harpenden, UK.
ALK-Abelló A/S, Hørsholm, Denmark.
Clinicoecon Outcomes Res. 2023 Feb 3;15:69-86. doi: 10.2147/CEOR.S377399. eCollection 2023.
Allergic rhinitis (AR) is an immunoglobulin E antibody-mediated inflammatory condition that arises in response to inhaled allergens such as pollen. Pollens from trees in the birch homologous group are the most common allergenic tree pollens in Northern and Central Europe and North America. SQ® Tree SLIT-Tablet (ITULAZAX®) is a sublingual immunotherapy tablet indicated for moderate-to-severe AR and/or conjunctivitis induced by pollen from the birch homologous group. The present analysis evaluated the cost-utility of treating adults with AR with SQ Tree SLIT-Tablet versus placebo, both in combination with symptom-relieving medications, from a Swedish societal perspective.
A model was developed to evaluate changes in cost and quality of life associated with using SQ Tree SLIT-Tablet relative to placebo in an adult population of individuals with AR. The model captured costs associated with symptom-relieving medications, healthcare professional interactions, SQ Tree SLIT-Tablet, and indirect costs arising from absenteeism and reduced workplace productivity. The analysis was conducted over 10 years with costs captured in 2021 Swedish Krona (SEK) and future costs and effects discounted at 3% per annum. One-way and probabilistic sensitivity analyses were conducted.
Treatment with SQ Tree SLIT-Tablet resulted in an improvement of 0.041 quality-adjusted life years (QALYs) over 10 years versus placebo. From a Swedish societal perspective, costs increased by SEK 9077 over the same period, resulting in an incremental cost-utility ratio of SEK 223,445 per QALY gained. One-way sensitivity analysis showed that the model was most sensitive to assumptions around the disease-modifying effect of SQ Tree SLIT-Tablet.
SQ Tree SLIT-Tablet improved quality of life in moderate-to-severe AR and/or conjunctivitis induced by pollen from the birch homologous group in Sweden, with only a modest increase in societal costs over a medium-term time horizon, representing good value for money at a willingness-to-pay threshold of SEK 700,000 per QALY.
变应性鼻炎（AR）是一种由免疫球蛋白E抗体介导的炎症性疾病，由吸入花粉等变应原引发。桦木同源组树木的花粉是北欧、中欧和北美的最常见致敏树木花粉。SQ® 树状特异性免疫治疗片（ITULAZAX®）是一种舌下免疫治疗片，适用于治疗由桦木同源组花粉引起的中重度AR和/或结膜炎。本分析从瑞典社会视角评估了使用SQ树状特异性免疫治疗片与安慰剂联合缓解症状药物治疗成人AR的成本效益。
建立一个模型，以评估在成年AR患者群体中，相对于安慰剂，使用SQ树状特异性免疫治疗片在成本和生活质量方面的变化。该模型涵盖了与缓解症状药物、医疗专业人员诊疗、SQ树状特异性免疫治疗片相关的成本，以及旷工和工作场所生产力下降所产生的间接成本。分析为期10年，成本以2021年瑞典克朗（SEK）计，未来成本和效果按每年3%进行贴现。进行了单向和概率敏感性分析。
与安慰剂相比，使用SQ树状特异性免疫治疗片治疗10年可使质量调整生命年（QALY）提高0.041。从瑞典社会视角来看，同期成本增加了9077瑞典克朗，每获得一个QALY的增量成本效益比为223,445瑞典克朗。单向敏感性分析表明，该模型对围绕SQ树状特异性免疫治疗片疾病改善效果的假设最为敏感。
在瑞典，SQ树状特异性免疫治疗片改善了由桦木同源组花粉引起的中重度AR和/或结膜炎患者的生活质量，在中期时间范围内社会成本仅适度增加，在每QALY支付意愿阈值为700,000瑞典克朗时具有良好的性价比。
