OBJECTIVES: Specific immunotherapy (SIT) is the only potentially curative therapy in patients with allergic rhinitis (AR) and allergic asthma (AA). The present study examined the effects of specific immunotherapy (SIT) on the financial situation of the German statutory health insurance systems (SHI). METHODS: Taking population projections of the German Statistical Federal Office, the number of expected new cases (AR, AA) was calculated until 2050. Based on assumptions about the proportion of patients who received SIT in the future, age cohorts passed cost-effectiveness models that were based on Markov chains. For determining the cost situation of SIT remedies, we used selling prices for Allergovit® depot suspensions. All future costs are discounted at a rate of 2%. Data on effectiveness were extracted from published literature. The model calculation was supplemented by a Delphi panel and additional probabilistic sensitivity analysis. RESULTS: Based on the current situation, a total annual economic burden of € 1 billion is expected for care of patients with pollen-induced AR and AA in Germany. Several realistic scenarios have shown, that despite higher initial expenses, savings of up to 10% of the average total annual cost are realizable. That would mainly driven by a reduced number of patients suffering from AA. The size of this cost reduction is mainly affected by the starting point of therapy: If SIT is applied at an early disease stage without asthma symptoms, the expected number of asthma sufferers is up to 35% lower compared to status quo. CONCLUSIONS: From the perspective of statutory health insurance companies, SIT could be a useful strategic option to prevent future allergic disease cases and to reduce associated medical expenses.