OBJECTIVES: Grass pollen induced allergic rhinoconjunctivitis (ARC) constitutes a large burden for the society. The prevalence is increasing and up to 20% of the European and US populations suffer from respiratory allergies including grass pollen induced ARC. The majority of patients are treated with symptomatic medications; however a large proportion remains uncontrolled despite the use of such treatments. Specific immunotherapy (SIT) is the only treatment documented to target the underlying cause of the allergic disease leading to a sustained effect after treatment completion. The aim of this study was to compare the economic consequences of treatment of patients with ARC with a grass allergy immunotherapy tablet (AIT) and the clinical practice of subcutaneous immunotherapy (SCIT). METHODS: A cost-minimisation analysis (CMA) was applied comparing the SQ-standardised grass AIT (Grazax, Phleum pratense, 75,000 SQ-T/2,800 BAU, ALK, Denmark) with SCIT (Alutard, Phleum pratense, 100,000 SQ-U/ml, ALK, Denmark). The CMA included health care utilisation measured in physical units based on national guidelines, literature reviews and expert opinions, as well as valuation in unit costs based on drug tariffs, physician fee structures and wage statistics. The CMA was conducted from a Danish societal and health care perspective. RESULTS: Treating patients with ARC with the grass AIT instead of grass SCIT results in a significantly reduced number of physician visits leading to a total reduction in direct treatment costs, direct patient costs as well as in indirect costs of €3526 per patient during a treatment course. A one-way sensitivity analysis confirmed the robustness of these results. CONCLUSIONS: The cost minimisation analyse shows that grass AIT is a cost-saving alternative to SCIT when treating patients suffering from grass pollen induced ARC.