Mauro Minelli, immunologo clinico ed allergologo

Economic evaluation of sublingual immunotherapy: an analysis of literature.
Eur Ann Allergy Clin Immunol. 2007;39 Spec No:21-6
Ciprandi G, Agostinis F, Amoroso S, Ariano R, Barbato A, Bassi M, Cadario G, Campi P, Cardinale F, Romano C, Incorvaia C, Danneo R, Dal Bo S, Di Gioacchino M, Fiocchi A, Galimberti M, Galli E, Giovannini M, La Grutta S, Lombardi C, Marcucci F, Marseglia GL, Mastrandrea F, Minelli M, Nettis E, Novembre E, Ortolani C, Pajno G, Piras PP, Passalacqua G, Patriarca G, Pucci S, Quercia O, Romano A, Schiavino D, Sforza M, Tosca MA, Tripodi S, Zambito M, Puccinelli P, Frati F.

Dipartimento di malattie immuno-allergologiche, Semeiotica medica I, Ospedale Universitario S. Martino, Genoa, Italy.
Allergic rhinitis and asthma constitute a global health problem because of their very high prevalence and the consequent burden of disease, concerning medical and economical issues. Among the treatments of allergy, specific immunotherapy has the capacity to favourably alter the natural history of the disease both during and after its performance and thus to reduce the direct and indirect costs of allergic rhinitis and asthma. A number of studies reported such cost reduction for traditional, subcutaneous immunotherapy and recent data demonstrate that also sublingual immunotherapy (SLIT) is associated to economic advantages and/or monetary savings, specifically in terms of reduction of disease economic burden. Only few formal economic assessments of SLIT have been carried out so far, this article will present and discuss the published studies addressed to this issue. The data obtained, although the number of studies is still limited, provide preliminary evidence supporting a SLIT effect on sparing costs for respiratory allergy.

PMID: 18924463 [PubMed - indexed for MEDLINE]

Pharmacoeconomics of subcutaneus allergen immunotherapy.
European annals of Allergy and Clinical Immunology Vol. 39- Special number- 2001 pp:21-26

Incorvaia C, Agostinis F, Amoroso S, Ariano R, Barbato A, Bassi M, Cadario G, Campi P, Cardinale F, Romano C, Ciprandi G, D’Anneo R, Dal Bo S, Di Gioacchino M, Fiocchi A, Galimberti M, Galli E, Giovannini M, La Grutta S, Lombardi C, Marcucci F, Marseglia GL, Mastrandrea F, Minelli M, Nettis E, Novembre E, Ortolani C, Pajno G, Piras PP, Passalacqua G, Patriarca G, Pucci S, Quercia O, Romano A, Schiavino D, Sforza M, Tosca MA, Tripodi S, Zambito M, Puccinelli P, Frati F.
Allergologia, Istituti Clinici di Perfezionamento, Milan, Italy.
The current burden of allergic diseases, estimated by both direct and indirect costs, is very relevant. In fact the cost estimation for rhinitis amount globally to 4-10 billion dollars/year in the U.S. and to an average annual cost of 1089 euros per child/adolescent and 1543 euros per adult in Europe. The estimated annual costs in Northern America for asthma amounted to 14 billion dollars. Consequently, preventive strategies aimed at reducing the clinical severity of allergy are potentially able to reduce its costs. Among them, specific immunotherapy (SIT) joins to the preventive capacity the carryover effect once treatment is discontinued. A number of studies, mainly conducted in the US and Germany demonstrated a favourable cost-benefit balance. In the nineties, most surveys on patients with allergic rhinitis and asthma reported significant reductions of the direct and indirect costs in subjects treated with SIT compared to those treated with symptomatic drugs. This is fully confirmed in recent studies conducted in European countries: in Denmark the direct cost per patient/year of the standard care was more than halved following SIT; in Italy a study on Parietaria allergic patients demonstrated a significant difference in favor of SIT plus drug treatment for three years versus drug treatment alone, with a cost reduction starting from the 2nd year and increasing to 48% at the 3rd year, with a highly statistical significance which was maintained up to the 6th year, i.e. 3 years after stopping immunotherapy, corresponding to a net saving for each patient at the final evaluation of 623 euros per year; in France a cost/efficacy analysis comparing SIT and current symptomatic treatment in adults and children with dust mite and pollen allergy showed remarkable savings with SIT for both allergies in adults and children.

PMID: 18924462 [PubMed - indexed for MEDLINE]