OBJECTIVES: A curative treatment for patients with Allergic Rhinitis (AR) is immunotherapy (IT). However, not all patients are susceptible for IT, and many patients currently receive this  treatment without any effect. Component Resolved Diagnosis (CRD) is a technique that might help identifying susceptible patients for IT. This study aimed to evaluate the impact of diagnosing patients with AR with CRD on treatment prescription, costs and (health) outcomes compared to diagnosing patients with standard testing (Skin Prick Testing (SPT)) in the Netherlands. METHODS: A literature search and interviews with experts were performed to structure a decision tree and to determine relevant parameters for the analysis. Parameter values were based on literature data; costs were retrieved from national databases. Primary outcomes were the incremental cost per additional full responder and the incremental cost per Quality Adjusted Life Year (QALY) over a time horizon of nine years. RESULTS: Diagnosis through CRD increased the number of full responders to IT compared to diagnosing patients with SPT (13,239 [95%CI; 10,039 – 16,868] vs 9,422 [95%CI; 7,384 – 11,891]). QALYs also increased more for patients on IT based on CRD compared to patients diagnosed with SPT (0.02734 [95%CI; -0.0216 – 0.0338] vs 0.02362 [95%CI; 0.0201 – 0.0276]). Expected total costs per patient reduced when diagnosis took place with CRD, from €7,555 [95%CI; €7,496 – €7,618] to €7,255 [95%CI; €7,062 – 7,453]. The incremental cost per additional full responder and the incremental cost per Quality Adjusted Life Year (QALY) were €-12,773 and €-80,667 respectively. The PSA showed that in 96.4% of the 10,000 simulations CRD was dominant in both costs and additional full responders, and in 84.8% in both costs and additional QALYs. CONCLUSIONS: Using CRD in the diagnosis of patients with suspected AR seems to be both cost saving as improving treatment decisions and health outcomes.