Pharmacoeconomic analysis of bronchial asthma prophylaxis in adults and children with allergic rhinitis with sublingual allergen-specific immunotherapy
AIMS: to evaluate the cost-effectiveness of sASIT in children and adult patients with allergic rhinitis and / or allergic rhinoconjunctivitis. MATERIALS AND METHODS: the hypothesis of the study was based on results of the study by Devillier P. et al., 2019, according to which the incidence of asthma was 13.7% and 17.0% in the sASIT + symptomatic therapy groups and the symptomatic therapy group (odds ratio - 0.776, 95% confidence interval (0.622; 0.968)). Pharmacoeconomic study based on decision tree model. Costs taken into account: cost of sASIT, symptomatic therapy, diagnostics and routine follow-up visits due to BA, outpatient BA drug therapy, the cost of hospitalization due to BA. The modeling horizon was 5 years, including 2 years of sASIT therapy and 3 years of follow-up. RESULTS: the cost per patient when using sASIT in combination with symptomatic therapy was 166,711.93 rubles, with symptomatic therapy - 101,700.35 rubles. The CER for sASIT in combination with symptomatic therapy was 193,177.20 rubles. per 1 prevented case of asthma, for symptomatic therapy - 122,530.55 rubles. for 1 prevented case of BA. Thus, the cost of 1 averted AB case when using sASIT in combination with symptomatic therapy is 57.7% higher than with symptomatic therapy. According to the results of the cost-benefit analysis, ICUR for an additional year of life adjusted for its quality (QALY) when performing sASIT in combination with symptomatic therapy compared with symptomatic therapy alone in children and adults was 567,365.48 rubles, which is less than calculated willingness to pay threshold (WTPT) (RUB 2,248,898.50). CONCLUSIONS: based on the results of comparing the cost of 1 added QALY and WTPT, it can be concluded that sASIT in combination with symptomatic therapy compared to symptomatic therapy alone is potentially cost-effective in children and adults with AR.