RWD in Cost-Effectiveness Studies
Management of patients suffering from AR results in high financial
burden to patients, health-care providers and society (51). Several
pharmacoeconomic studies conducted from a health system perspective in
Europe and using QALYS as their outcome measure have reported strong
evidence that AIT is cost-effective in the management of AR and asthma
compared with symptomatic treatment alone (52–59). The magnitude of
cost-effectiveness is likely underestimated because most of the studies
did not consider long-term benefits or preventive and prophylactic
effects but only costs during the treatment period (60).
Cost-effectiveness studies for AIT are based on efficacy data from RCTs
or metanalyses and usually include results for medication adherence from
RWD. There are several analyses investigating cost-effectiveness of
grass pollen AIT for different European countries using adherence data
from various sources (52,54–56,58,59). All proved cost-effectiveness of
SCIT and SLIT compared to symptomatic treatment for patients with
allergic rhinitis or rhinoconjunctivitis. For AR, the most recent study
analyzing the cost-effectiveness of a SCIT allergoid and a SLIT tablet
in Germany showed that SCIT and SLIT are cost-effective compared to
symptomatic treatment with SCIT appearing dominant due to higher patient
adherence and lower drug costs (17,58). This cost-effectiveness study
was the first using drug and treatment costs and RWD adherence data for
the same preparations in the same country instead of including data of a
combination of AIT preparations or data from other countries as a basis
(52,54–56,59).