过敏与治疗杂志

抽象的

Cost-Effectiveness of Allergen Immunotherapy

Cristoforo Incorvaia, Patrizia Berto, Renato Ariano, Rita Elia and Franco Frati

The current burden of allergic diseases, considering both direct and indirect costs, is very relevant. In fact the estimated cost for allergic rhinitis (AR) is 4-10 billion dollars/year in the US and averages an annual cost of 1089 euros per child/adolescent and 1543 euros per adult in Europe. The cost is obviously higher when including also allergic asthma. Strategies aimed at reducing the clinical severity of allergy are therefore most relevant from both a societal and healthcare system’s perspective. Among them, allergen immunotherapy (AIT) showed preventive capacity and also a carryover effect once treatment is discontinued, thus further reducing the costs. A number of studies demonstrated a favorable cost-benefit ratio for AIT. The first studies in the 1990s evaluating subcutaneous AIT in patients with allergic rhinitis and asthma, reported significant reductions of direct and indirect costs in subjects treated with AIT, as compared to those treated with symptomatic drugs. This was fully confirmed in recent studies conducted in European countries, also including sublingual immunotherapy, as well as in studies conducted in the US. In particular, the conclusion of a recent study on health care cost benefits of AIT in children with AR suggesting that “Greater use of this treatment in children could significantly reduce AR-related morbidity and its economic burden” should be kept in mind when considering the optimal choice of medical treatment in patients with AR or asthma.