Cost‐effectiveness of the subcutaneous house dust mite allergen immunotherapy plus pharmacotherapy for allergic asthma: A mathematical model

Padilla, D. Parra; Zakzuk, Josefina; Carrasquilla, M.; Alvis‐Guzmán, Nelson; Dennis, Rodolfo; Rojas, María Ximena; Rondón, Martín; Pérez, Adriana; Peñaranda, Augusto; Barragan, Ana M; Caraballo, Luis; García, Elizabeth

doi:10.1111/all.14723

Cited by 9 publications

(15 citation statements)

References 11 publications

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“…Third, we conducted an extensive analysis considering another scenario that we believed to be relevant for interpreting the results among different contexts. Our results are in line with those obtained for SCIT in the aforementioned study 18 ; the small differences may be due to the inclusion of compliance data and medication step‐up in the model and the differences in the input data according to each country specifications. Another study evaluated the cost‐effectiveness of SLIT in adults with asthma sensitized to HDM in three European countries 22 .…”

Section: Discussionsupporting

confidence: 90%

“…Abbreviations: GINA, global initiative for asthma; HDM, house dust mite; ICER, incremental cost-effectiveness ratio; QALYs, quality-adjusted life-years; SCIT, subcutaneous immunotherapy; SLIT, sublingual immunotherapy; SOC, standard of care We developed a hypothetical Markov model to evaluate the costs and health outcomes of HDM allergen immunotherapy, for both SLIT tablets and SCIT, in children with allergic asthma plus pharmacotherapy compared with pharmacotherapy alone (SOC). The adopted framework used the stepwise approach of GINA (Global Strategy for Asthma Management and Prevention of the Global Initiative of Asthma) to define health states and was based on a previous cost analysis study conducted by Parra-Padilla et al 18 For the mathematical model; we simulated a hypothetical cohort of 12-year-old children, 1000 per strategy, over a 10-year horizon divided into 6month cycles and following the Portuguese healthcare system perspective. The cycle length was defined to represent the average of medical visits scheduled in a year and allow adjustments in asthma therapy as in real-life.…”

Section: G R a P H I C A L Abstractmentioning

confidence: 99%

“…Costs and QALYs were discounted at 3% per year as performed in previous studies. 18,22 The cost-effectiveness threshold (CE threshold) was based on WHO recommendations as one to three times the gross domestic product (GDP) per capita of the country. 23 We considered the value corresponding to the lowest category suggested by WHO-thus, up to one time the GDP per capita.…”

Section: Model Calculationmentioning

confidence: 99%

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Cost‐effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma

Farraia

Paciência

Mendes

et al. 2022

Allergy

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Background:Cost-effectiveness studies evaluating allergen immunotherapy (AIT) in children are limited but needed to drive clinical and policy-making decisions such as reimbursement of new interventions. In this study, we compared the cost effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) tablets to the standard of care (SOC) treatment in children with house dust mite-driven (HDM) allergic asthma. Methods:We developed a hypothetical Markov model based on the Global Initiative for Asthma (GINA) severity steps to compare the three strategies over a 10-year horizon divided by cycles of 6 months. SOC was used as a reference to calculate the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were used to assess models' uncertainty. Other scenarios were evaluated to strengthen the presentation of results. Results:The ICER for SCIT and SLIT tablets was 1281€ and 7717€, respectively. The cost-effectiveness threshold for Portugal was 18,482.80€; both treatment approaches were below this limit. The major contributors to these results were the AIT effects on reducing moderate and severe exacerbations and asthma controller medication. In the sensitivity analysis, SCIT revealed a higher probability of cost-effectiveness than SLIT. When including allergic rhinitis as comorbidity, ICER values reduced markedly, especially for SCIT intervention.Conclusions: AIT was cost effective in children with HDM-driven allergic asthma, especially when given by the subcutaneous route. The high probability of cost effectiveness, especially for SCIT, may drive future policy decisions and AIT-prescribing habits.AIT adherence greatly influenced the results highlighting the value of implementing strategies to promote adherence rates.

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Section: Discussionsupporting

confidence: 90%

Section: G R a P H I C A L Abstractmentioning

confidence: 99%

Section: Model Calculationmentioning

confidence: 99%

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Cost‐effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma

Farraia

Paciência

Mendes

et al. 2022

Allergy

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“…An interesting study using a cohort state‐transition model (Markov model) evaluated the potential consequences in costs and health‐related quality of life of the evaluated strategies in the clinical pathway of asthmatic patients over a 10‐year time horizon. The results suggested that subcutaneous immunotherapy added to ICS is cost‐effective compared with ICS in the reduction of exacerbations and the discontinuation of rescue and controller medications 113 …”

Section: Real‐world Evidence and Pharmacoeconomic Considerationsmentioning

confidence: 99%

Advances and highlights in asthma in 2021

Agache

Eguiluz‐Gracia

Cojanu

et al. 2021

Allergy

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Last year brought a significant advance in asthma management, unyielding to the pressure of the pandemics. Novel key findings in asthma pathogenesis focus on the resident cell compartment, epigenetics and the innate immune system. The precision immunology unbiased approach was supplemented with novel tools and greatly facilitated by the use of artificial intelligence. Several randomised clinical trials and good quality realworld evidence shed new light on asthma treatment and supported the revision of several asthma guidelines (GINA, Expert Panel Report 3, ERS/ATS guidelines on severe asthma) and the conception of new ones (EAACI Guidelines for the use of biologicals in severe asthma). Integrating asthma management within the broader context of Planetary Health has been put forward. In this review, recently published articles and clinical trials are summarised and discussed with the goal to provide clinicians and researchers with a concise update on asthma research from a translational perspective.

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“…Un estudio latinoamericano apunta a un probable efecto económico favorable al manejar ITA con ácaros en asma alérgica. 33 A diferencia de la farmacoterapia, los efectos benéficos de un esquema de tres años de ITA pueden perdurar por meses o años después de terminarla (GEMA, evidencia B), ya que modifica los mecanismos inmunológicos subyacentes y, con ello, la historia natural de las enfermedades alérgicas.…”

Section: Asma Alérgica: Inmunoterapia Con Alérgenosunclassified

MIA 2021, Manejo Integral del Asma. Lineamientos para México

Larenas‐Linnemann

Salas-Hernández

Río-Navarro

et al. 2021

RAM

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Antecedentes: El asma sigue siendo una patología respiratoria crónica frecuente en México. Se han descrito nuevos métodos para el diagnóstico y tratamiento conforme se renuevan las guías internacionales. Objetivo: Crear la plataforma nacional Manejo Integral del Asma (MIA), para el desarrollo de lineamientos actualizados con base en evidencia. Métodos: Se utilizó el método ADAPTE. El grupo de desarrollo de MIA estuvo integrado por expertos en neumología, alergología y metodología y representantes de 13 instituciones y sociedades de especialidades que manejan asma. Las guías internacionales de referencia (seleccionadas con AGREE-II) fueron GINA 2020, GEMA 5.0, BTS/SIGN 2019 y consenso ATS/ERS 2014-2019. En MIA se aborda sospecha de asma, diagnóstico, tratamiento y grupos especiales. Se formularon preguntas clínicas clave sobre tratamiento en los pasos 1 a 3, biomarcadores y asma grave. Resultados: Con base en evidencia, seguridad, costo y realidad local, el grupo nuclear desarrolló respuestas. Mediante proceso Delphi, el grupo amplio de desarrollo sugirió ajustes hasta que se logró el consenso. Conclusión: El documento generado contiene múltiples figuras y algoritmos, está sólidamente basado en evidencia acerca del manejo del asma y fue ajustado para México con participación de diferentes sociedades para su desarrollo; no se incluyeron lineamientos para la crisis asmática. .

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Cost‐effectiveness of the subcutaneous house dust mite allergen immunotherapy plus pharmacotherapy for allergic asthma: A mathematical model

Cited by 9 publications

References 11 publications

Cost‐effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma

Cost‐effectiveness analysis of house dust mite allergen immunotherapy in children with allergic asthma

Advances and highlights in asthma in 2021

MIA 2021, Manejo Integral del Asma. Lineamientos para México

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