Cost-effectiveness of grass allergen tablet (GRAZAX®) for the prevention of seasonal grass pollen induced rhinoconjunctivitis -: a Northern European perspective

Background The prevalence of allergic rhinoconjunctivitis has increased dramatically. Seventeen million people in the United Kingdom, Germany, the Netherlands, Sweden, Denmark, Norway and Finland suffer from grass pollen induced allergic rhinitis. Symptomatic therapy with antihistamines and topical steroids is partially effective but allergen-specific immunotherapy by injection or sublingual routes is superior. The grass allergen tablet (GRAZAX((R))) is a new allergen-specific immunotherapy for home administration. Objective To assess the cost-effectiveness of the grass allergen tablet compared with symptomatic medication in seven Northern European countries. Methods A prospective pharmacoeconomic analysis was carried out alongside a multinational clinical trial. Pooled data on resource use and health outcomes were collected. A societal perspective was adopted, and the analysis had a 9-year time horizon. The outcome measure was Quality Adjusted Life Years (QALYs). Results The grass allergen tablet was clinically superior to symptomatic treatment, producing statistically significant differences for all efficacy end-points, including the number of QALYs gained - 0.976 vs. 0.947 QALYs gained. There was a significantly higher usage of the rescue medications loratadine and budesonide, and more hours missed from work (production loss), in the symptomatic treatment group. The cost per QALY gained in the grass allergen tablet group was similar in the seven countries (e12 930 to e18 263 for an annual cost of the grass allergen tablet of e1500). The analysis showed that the grass allergen tablet was cost-effective for all countries for an annual treatment cost below e2200. Conclusion The pharmacoeconomic analysis illustrated that allergen-specific immunotherapy with the grass allergen tablet is a cost-effective intervention for the prevention of grass pollen induced rhinoconjunctivitis in Northern European countries, for a tablet price below e6. In Germany for example the price of the tablet is e2.95 corresponding to a yearly treatment cost of e358 - based on a 9-year time horizon.