OBJECTIVES

: A symptomatic therapy (ST) is often used as the standard care of treatment in Poland in patients with persistent moderate-to-severe house dust mite (HDM) allergic rhinitis (AR). HDM sublingually administered allergy immunotherapy tablet (SQ® HDM SLIT-tablet) may be a technology better suited to the patient's preferences, reducing the severity of disease symptoms and improving the quality of life. The purpose of this analysis was to compare the costs and effects related to treatment and administration of SQ® HDM SLIT-tablet plus ST with ST alone in Poland in the population with HDM AR with or without allergic asthma (AA) uncontrolled by inhaled corticosteroids.

METHODS

: A cost-utility analysis was performed using a decision tree economic model. The structure of the model, dosage of drugs and health state utilities were based on MITRA (MT-04) and MERIT (MT-06) trials (for populations with and without AA, respectively). Relevant costs associated with treatments were included from public payer’s and common (public payer’s and patient’s) perspectives. A five-year time horizon was adopted. Due to the favorable safety profile of SQ® HDM SLIT-tablet (mild, transient adverse events that occur mainly in the initial phase of treatment) no additional disutility or costs were assumed.

RESULTS

: Incremental cost-utility ratio (ICUR) amounts to PLN/QALY 21,050 (population with AA) and PLN/QALY 20,960 (population without AA) from public payer perspective due to improved health outcomes with slightly higher costs of SQ® HDM SLIT-tablet compared to ST. Results from common perspective are slightly higher (ICUR values PLN/QALY 39,394 and 39,833, respectively).

CONCLUSIONS

: According to the current Polish willingness to pay threshold (PLN 134,514; 3xGDP per capita) SQ® HDM SLIT-tablet is a highly cost-effective intervention for the target population in comparison to ST. Immunotherapy with SQ® HDM SLIT-tablet is associated with additional health benefits that could not be achieved with optimal ST.