Evidence map›Paper›PMID 29574666›Full record

ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2018

Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach.

Ann-Kathrin Richter, Ludger Klimek, Hans F Merk, Norbert Mülleneisen, Harald Renz, Wolfgang Wehrmann, Thomas Werfel, Eckard Hamelmann, Uwe Siebert, Gaby Sroczynski and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Guideline on allergen immunotherapy in IgE-mediated allergic diseases: S2K Guideline of the German Society of Allergology and Clinical Immunology (DGAKI), Society of Pediatric Allergology and Environmental Medicine (GPA), Medical Association of German Allergologists (AeDA), Austrian Society of Allergology and Immunology (ÖGAI), Swiss Society for Allergology and Immunology (SSAI), German Dermatological Society (DDG), German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), German Society of Pediatrics and Adolescent Medicine (DGKJ), Society of Pediatric Pulmonology (GPP), German Respiratory Society (DGP), German Professional Association of Otolaryngologists (BVHNO), German Association of Paediatric and Adolescent Care Specialists (BVKJ), Federal Association of Pneumologists, Sleep and Respiratory Physicians (BdP), Professional Association of German Dermatologists (BVDD).Allergologie select · 2022
    Article
  3. Cost-Effectiveness Of The SQClinicoEconomics and outcomes research : CEOR · 2019
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 2 countries.

Ann-Kathrin RichterInstitute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany. Ann-Kathrin.Richter@medman.uni-due.de.ORCID http://orcid.org/0000-0003-4351-3458
Ludger KlimekCentre for Rhinology and Allergology, Wiesbaden, Germany.
Hans F MerkClinic for Dermatology and Allergology, University Clinic RWTH, Aachen, Germany.
Norbert MülleneisenAsthma and Allergy Centre, Leverkusen, Germany.
Harald RenzInstitute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University, Marburg, Germany.
Wolfgang WehrmannDermatological Clinic Prof. Wehrmann, Dr. Rödder-Wehrmann and colleagues, Münster, Germany.
Thomas WerfelDivision of Immunodermatology and Allergy Research, Dept of Dermatology and Allergy, Hannover Medical School, Hanover, Germany.
Eckard HamelmannChildren's Center Bethel, Protestant Hospital Bielefeld and Allergy Center Ruhr-University, Bochum, Germany.
Uwe SiebertDepartment of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
Gaby SroczynskiDepartment of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.
Jürgen WasemInstitute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
Janine Biermann-StallwitzInstitute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
University of Duisburg-Essen · DEEvangelisches Krankenhaus Bielefeld · DEHarvard University · USKlinikum Leverkusen · DEMedizinische Hochschule Hannover · DEPhilipps University of Marburg · DERWTH Aachen University · DEZentrum für Rhinologie und Allergologie · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpecific immunotherapy is the only causal treatment in respiratory allergy. Due to high treatment cost and possible severe side effects subcutaneous immunotherapy (SCIT) is not indicated in all patients. Nevertheless, reported treatment rates seem to be low. This study aims to analyze the effects of increasing treatment rates of SCIT in respiratory allergy in terms of costs and quality-adjusted life years (QALYs).

methodsA state-transition Markov model simulates the course of disease of patients with allergic rhinitis, allergic asthma and both diseases over 10 years including a symptom-free state and death. Treatment comprises symptomatic pharmacotherapy alone or combined with SCIT. The model compares two strategies of increased and status quo treatment rates. Transition probabilities are based on routine data. Costs are calculated from the societal perspective applying German unit costs to literature-derived resource consumption. QALYs are determined by translating the mean change in non-preference-based quality of life scores to a change in utility. Key parameters are subjected to deterministic sensitivity analyses.

resultsIncreasing treatment rates is a cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of 3484€/QALY compared to the status quo. The most influential parameters are SCIT discontinuation rates, treatment effects on the transition probabilities and cost of SCIT. Across all parameter variations, the best case leads to dominance of increased treatment rates while the worst case ICER is 34,315€/QALY. Excluding indirect cost leads to a twofold increase in the ICER.

conclusionsMeasures to increase SCIT initiation rates should be implemented and also address improving adherence.

Indexed as

Cost of IllnessComputer SimulationCosts and Cost AnalysisDecision Support Systems, ClinicalGermanyHumansImmunotherapyMarkov ChainsQuality-Adjusted Life YearsRespiratory HypersensitivitySubcutaneous AbsorptionCost-utility analysisMarkov processRespiratory allergyState-transition modelSubcutaneous immunotherapy

Identifiers

PMID29574666
OpenAlexW2792051672

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.