Direct Costs and Time-Use Related to Subcutaneous Immunotherapy in Spanish Patients with Allergic Rhinitis: Across-Sectional Survey

Abstract

Background: Literature has shown that subcutaneous immunotherapy (SCIT) is time-consuming and costly for patients in Canadian and US settings. However, there is no evidence of the patient time-use and direct patient costs related to SCIT in a Spanish setting. The objective of this study was to investigate self-reported direct costs and timeuse related to SCIT among both caregivers of children with allergic rhinitis (AR) and adults with AR in a Spanish setting. Methods:In this cross-sectional study, 286 adults and 513 caregivers of children with symptomatic AR of at least moderate severity who are currently or have previously received allergy immunotherapy (AIT) entered the questionnaire. We excluded respondents who partly completed the survey, who are receiving or have received AIT using a sublingual or an unknown route, or who stopped AIT more than five years earlier. 87 adults and 289 caregivers of children (aged 5-17) were included. An electronic survey was conducted to collect self-reported time-use and direct costs related to transportation associated with the participants' most recent SCIT visit. Univariate descriptive statistics were used to analyze data. Results:Results showed that adults on SCIT spend a total of 60 minutes per clinic visit, whereas caregivers and children spend a total of 50 minutes per visit, including transportation time and time spent at the clinic. Most adults and accompanying adults did not uphold any direct costs related to either parking, road tolls or other transportrelated costs when receiving SCIT. The majority of adults, caregivers and children missed work or school due to SCIT. We found that a median of 3 hours of work or school was missed per visit. Conclusion:Our findings indicate that SCIT entails substantial time-use and productivity loss for adults with AR as well as caregivers of children with AR in Spain. Furthermore, we found that treatment with SCIT has a negative impact on the educational attendance among children with AR.