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).