TY - JOUR

T1 - Kosten und Nutzen der Hyposensibilisierung bei allergischem Asthma und Rhinitis

AU - Greiner, W.

AU - Graf, J. M.

AU - Gillissen, A.

PY - 2003/6

Y1 - 2003/6

N2 - Aim: Specific immune therapy (SIT) of polling allergy patients with allergic asthma and/or rhinitis by standardised and molecularly defined allergen preparations can lead to a symptom-free status or to a palliation of the symptoms on a long-term basis. The primary goal of this health economic evaluation study is the estimation of the direct cost effects of SIT compared with the costs associated with a symptomatic therapy without SIT. The secondary goal of the study is the evaluation of the long-term cost effects for the duration of 25 years after the start of SIT. Method: The costs were analysed retrospectively in specialised and GP practices for the period of three years in two groups of patients: The first group of patients had just terminated the SIT. The second group of patients would have been applicable for a SIT, but rejected to choose this therapy or the physician had not offered it. Costs and benefits of the therapy were modelled for a period of 25 years. The robustness of the results was examined in a sensitivity analysis by varying the duration of treatment effectiveness and resource prices. Results/Conclusions: The average total costs of treatment per year was more than halved by the SIT (in particular by lower drug expenses) (393.05 € versus 189.86 €), hospital costs did not arise in both groups. The indirect costs of the illness per employed patient amounted to 46.20 €; in the SIT group and 356.40 € in the control group. For the long-term modelling the costs of the SIT was considered as well. 25 years after the treatment net savings amount to 2,501.60 € (including the costs of SIT), i.e. that after this period the additional expenditures of SIT are more than balanced in comparison to the control group. Discounted savings are less significant (603.91 €). Net savings depend to a large amount on the price of ambulatory care and react less sensible to changes of the discount rate. Changes of the duration of the SIT effectiveness were only of minor significance for the study results. In case of sufficient diagnosis and correct application SIT represents an effective and on a long-term basis cost-saving therapy option.

AB - Aim: Specific immune therapy (SIT) of polling allergy patients with allergic asthma and/or rhinitis by standardised and molecularly defined allergen preparations can lead to a symptom-free status or to a palliation of the symptoms on a long-term basis. The primary goal of this health economic evaluation study is the estimation of the direct cost effects of SIT compared with the costs associated with a symptomatic therapy without SIT. The secondary goal of the study is the evaluation of the long-term cost effects for the duration of 25 years after the start of SIT. Method: The costs were analysed retrospectively in specialised and GP practices for the period of three years in two groups of patients: The first group of patients had just terminated the SIT. The second group of patients would have been applicable for a SIT, but rejected to choose this therapy or the physician had not offered it. Costs and benefits of the therapy were modelled for a period of 25 years. The robustness of the results was examined in a sensitivity analysis by varying the duration of treatment effectiveness and resource prices. Results/Conclusions: The average total costs of treatment per year was more than halved by the SIT (in particular by lower drug expenses) (393.05 € versus 189.86 €), hospital costs did not arise in both groups. The indirect costs of the illness per employed patient amounted to 46.20 €; in the SIT group and 356.40 € in the control group. For the long-term modelling the costs of the SIT was considered as well. 25 years after the treatment net savings amount to 2,501.60 € (including the costs of SIT), i.e. that after this period the additional expenditures of SIT are more than balanced in comparison to the control group. Discounted savings are less significant (603.91 €). Net savings depend to a large amount on the price of ambulatory care and react less sensible to changes of the discount rate. Changes of the duration of the SIT effectiveness were only of minor significance for the study results. In case of sufficient diagnosis and correct application SIT represents an effective and on a long-term basis cost-saving therapy option.

KW - Asthma

KW - Cost analysis

KW - Polling allergy

KW - Rhinitis

KW - Specific immune therapy

UR - http://www.scopus.com/inward/record.url?scp=0041825151&partnerID=8YFLogxK

U2 - 10.1055/s-2003-40480

DO - 10.1055/s-2003-40480

M3 - Artikel

AN - SCOPUS:0041825151

VL - 8

SP - 179

EP - 186

JO - Gesundheitsokonomie und Qualitatsmanagement

JF - Gesundheitsokonomie und Qualitatsmanagement

SN - 1432-2625

IS - 3

ER -