D3.182 - Health Economic Evaluation of 5-Grass Pollen Sublingual ImmunotherapyTablets for Grass Pollen-Induced Allergic Rhinitis in Finland, Norway and Sweden

Symptom and medication scores of 5-grass pollen (5-GP) and 1-GP sublingual immunotherapy (SLIT) tablets were comparable in indirect treatment comparisons (i.e., they had similar short- and long-term efficacy in the treatment of GP–induced allergic rhinitis). However, the economic impact of these treatments was unevaluated. Here, we evaluate the cost differences of 5-GP and 1-GP SLIT treatments.

Based on the premise of similar efficacy and clinical equivalence, a cost-minimisation analysis focusing on drug acquisition costs was conducted to compare 5-GP and 1-GP SLIT tablets from the perspective of healthcare payers in Finland, Norway, and Sweden. Namely, no cost differences were identified between treatments regarding treatment initiation, administration, monitoring, or indirect costs. The base-case analysis applied the most-prescribed pack sizes of 90/100 tablets for 5-GP/1-GP after the initiation treatment packs of 31/30 tablets, respectively. Treatment duration was based on the recommended treatment schedules: 5-GP SLIT with pre- and co-seasonal usage for 210 treatment days per year and 1-GP SLIT with continuous usage for 365 days per year. Scenario analyses were conducted by modifying treatment adherence, pack size, and duration of the pollen season (including hypothetical 6-month and 8-month durations to assess the robustness of the results).

During the 3-year timeframe, 5-GP SLIT treatment resulted in cost savings of €1,855 (Finland), NOK 14,338 (Norway), and SEK 12,846 (Sweden) per patient compared with 1-GP SLIT treatment (Table 1). Furthermore, 5-GP SLIT treatment was cost saving compared with the 1-GP SLIT treatment across all 5 scenario analyses and in all 3 countries. Overall, 5-GP SLIT treatment demonstrated the largest cost savings in the base-case analysis and in scenario 1, in which 1-GP SLIT treatment was administered using a 100-tablet pack size throughout the treatment period. The least cost savings between the treatments were observed when the pollen season had a duration of 8 months, with cost savings ranging from -73€ to -407€ across countries.

This cost-minimisation analysis demonstrated cost savings associated with treating patients with 5-GP SLIT treatment compared with 1-GP SLIT treatment, and the results were robust across all scenario analyses. Overall, this evidence supports the potential of 5-GP SLIT treatment to save costs within a limited healthcare budget.