Immunotherapy Cuts Allergic Rhinitis Costs

SEATTLE — The cost of allergy immunotherapy among children with allergic rhinitis is quickly surpassed by savings in other health care costs, new data suggest.

“I am often asked by payers to justify the cost of allergy symptom treatments, allergy medications, and asthma medications,” said investigator Cheryl Hankin, Ph.D., president and chief scientific officer of BioMedEcon LLC, in Moss Beach, Calif. “It's amazing to me that payers rarely know that allergy immunotherapy is the only disease-modifying treatment available for children and patients with allergies.”

Research on the cost impact of this therapy in patients with asthma and allergic rhinitis in the United States has been limited, Dr. Hankin noted. Previous studies on the topic have yielded conflicting results.

In the retrospective study reported at the annual meeting of the American College of Allergy, Asthma, and Immunology, Dr. Hankin and her colleagues used a Florida Medicaid database to identify children younger than age 18 years given a new diagnosis of allergic rhinitis during a 9-year period (1997-2006). Children who received immunotherapy and had 18 months of follow-up data after starting the therapy were matched with children who did not receive immunotherapy according to age, comorbidities (atopic dermatitis, asthma, and conjunctivitis), sex, and race.

The investigators used Medicaid claims records to ascertain health care costs. Total health care costs were calculated as the sum of inpatient, outpatient, and medication costs.

Study results were based on 2,481 children who received immunotherapy and 150,615 children who did not. Analyses indicated that the median total cost of a course of immunotherapy over the 18-month period was $565, or about $35 per administration, Dr. Hankin said.

The median total health care costs per patient, including the cost of immunotherapy in the children who received it, were $1,809 or 29% lower in the immunotherapy group ($4,329 vs. $6,138).

In addition, the benefit began to emerge soon after the initiation of immunotherapy, according to Dr. Hankin. “At each time point, we were very surprised to find a highly significant effect, starting at 3 months, that continued to grow.” The cost of the immunotherapy was offset by savings in other health care costs after only 6 months.

When costs were broken down by type, children who did and did not receive immunotherapy had similar median inpatient costs. However, those receiving the therapy had significantly lower median medication costs ($1,469 vs. $1,698) and outpatient costs, including the cost of the immunotherapy itself ($2,391 vs. $3,329).

Discussing the study's findings, Dr. Hankin noted that they may not necessarily be generalizable to patients with private insurance or to adults. At the same time, she pointed out, the nature of the study permits an assessment of immunotherapy under real-world conditions.

Innovations such as sublingual allergy immunotherapy could reduce or remove barriers to accessing treatment, Dr. Hankin commented. “Reducing barriers to treatment may in fact reduce the cost of negative outcomes of allergic rhinitis, so we would expect that possibly this would reduce health care costs further, and further improve the health of children with allergic rhinitis.”

Dr. Hankin disclosed that she is a consultant for Greer Laboratories Inc., which also funded the study, and for Asthmatx Inc.

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SEATTLE — The cost of allergy immunotherapy among children with allergic rhinitis is quickly surpassed by savings in other health care costs, new data suggest.

“I am often asked by payers to justify the cost of allergy symptom treatments, allergy medications, and asthma medications,” said investigator Cheryl Hankin, Ph.D., president and chief scientific officer of BioMedEcon LLC, in Moss Beach, Calif. “It's amazing to me that payers rarely know that allergy immunotherapy is the only disease-modifying treatment available for children and patients with allergies.”

Research on the cost impact of this therapy in patients with asthma and allergic rhinitis in the United States has been limited, Dr. Hankin noted. Previous studies on the topic have yielded conflicting results.

In the retrospective study reported at the annual meeting of the American College of Allergy, Asthma, and Immunology, Dr. Hankin and her colleagues used a Florida Medicaid database to identify children younger than age 18 years given a new diagnosis of allergic rhinitis during a 9-year period (1997-2006). Children who received immunotherapy and had 18 months of follow-up data after starting the therapy were matched with children who did not receive immunotherapy according to age, comorbidities (atopic dermatitis, asthma, and conjunctivitis), sex, and race.

The investigators used Medicaid claims records to ascertain health care costs. Total health care costs were calculated as the sum of inpatient, outpatient, and medication costs.

Study results were based on 2,481 children who received immunotherapy and 150,615 children who did not. Analyses indicated that the median total cost of a course of immunotherapy over the 18-month period was $565, or about $35 per administration, Dr. Hankin said.

The median total health care costs per patient, including the cost of immunotherapy in the children who received it, were $1,809 or 29% lower in the immunotherapy group ($4,329 vs. $6,138).

In addition, the benefit began to emerge soon after the initiation of immunotherapy, according to Dr. Hankin. “At each time point, we were very surprised to find a highly significant effect, starting at 3 months, that continued to grow.” The cost of the immunotherapy was offset by savings in other health care costs after only 6 months.

When costs were broken down by type, children who did and did not receive immunotherapy had similar median inpatient costs. However, those receiving the therapy had significantly lower median medication costs ($1,469 vs. $1,698) and outpatient costs, including the cost of the immunotherapy itself ($2,391 vs. $3,329).

Discussing the study's findings, Dr. Hankin noted that they may not necessarily be generalizable to patients with private insurance or to adults. At the same time, she pointed out, the nature of the study permits an assessment of immunotherapy under real-world conditions.

Innovations such as sublingual allergy immunotherapy could reduce or remove barriers to accessing treatment, Dr. Hankin commented. “Reducing barriers to treatment may in fact reduce the cost of negative outcomes of allergic rhinitis, so we would expect that possibly this would reduce health care costs further, and further improve the health of children with allergic rhinitis.”

Dr. Hankin disclosed that she is a consultant for Greer Laboratories Inc., which also funded the study, and for Asthmatx Inc.

ELSEVIER GLOBAL MEDICAL NEWS

SEATTLE — The cost of allergy immunotherapy among children with allergic rhinitis is quickly surpassed by savings in other health care costs, new data suggest.

“I am often asked by payers to justify the cost of allergy symptom treatments, allergy medications, and asthma medications,” said investigator Cheryl Hankin, Ph.D., president and chief scientific officer of BioMedEcon LLC, in Moss Beach, Calif. “It's amazing to me that payers rarely know that allergy immunotherapy is the only disease-modifying treatment available for children and patients with allergies.”

Research on the cost impact of this therapy in patients with asthma and allergic rhinitis in the United States has been limited, Dr. Hankin noted. Previous studies on the topic have yielded conflicting results.

In the retrospective study reported at the annual meeting of the American College of Allergy, Asthma, and Immunology, Dr. Hankin and her colleagues used a Florida Medicaid database to identify children younger than age 18 years given a new diagnosis of allergic rhinitis during a 9-year period (1997-2006). Children who received immunotherapy and had 18 months of follow-up data after starting the therapy were matched with children who did not receive immunotherapy according to age, comorbidities (atopic dermatitis, asthma, and conjunctivitis), sex, and race.

The investigators used Medicaid claims records to ascertain health care costs. Total health care costs were calculated as the sum of inpatient, outpatient, and medication costs.

Study results were based on 2,481 children who received immunotherapy and 150,615 children who did not. Analyses indicated that the median total cost of a course of immunotherapy over the 18-month period was $565, or about $35 per administration, Dr. Hankin said.

The median total health care costs per patient, including the cost of immunotherapy in the children who received it, were $1,809 or 29% lower in the immunotherapy group ($4,329 vs. $6,138).

In addition, the benefit began to emerge soon after the initiation of immunotherapy, according to Dr. Hankin. “At each time point, we were very surprised to find a highly significant effect, starting at 3 months, that continued to grow.” The cost of the immunotherapy was offset by savings in other health care costs after only 6 months.

When costs were broken down by type, children who did and did not receive immunotherapy had similar median inpatient costs. However, those receiving the therapy had significantly lower median medication costs ($1,469 vs. $1,698) and outpatient costs, including the cost of the immunotherapy itself ($2,391 vs. $3,329).

Discussing the study's findings, Dr. Hankin noted that they may not necessarily be generalizable to patients with private insurance or to adults. At the same time, she pointed out, the nature of the study permits an assessment of immunotherapy under real-world conditions.

Innovations such as sublingual allergy immunotherapy could reduce or remove barriers to accessing treatment, Dr. Hankin commented. “Reducing barriers to treatment may in fact reduce the cost of negative outcomes of allergic rhinitis, so we would expect that possibly this would reduce health care costs further, and further improve the health of children with allergic rhinitis.”

Dr. Hankin disclosed that she is a consultant for Greer Laboratories Inc., which also funded the study, and for Asthmatx Inc.

ELSEVIER GLOBAL MEDICAL NEWS