A comparative evaluation of clinical and laboratory findings and treatment costs for sublingual and subcutaneous immunotherapy in children with allergic rhinitis and asthma

Abstract

Background:In our study we aim to determine the more effective,safe and economical method of immunotherapy in children withasthma and allergic rhinitis and to show the benefit of the long termtreatment of patients and the financial results of the treatments.Method:105 (SCIT=54, SLIT=51) patients who had conventionalsubcutaneous (SCIT) or sublingual (SLIT) treatment with standardpreparations for at least 3 years with allergic rhinitis and asthma inour clinic were included in the study. Clinical and immunological effi-cacy is evaluated. In terms of cost effectiveness, costs such as directmedical expenses and direct non‐medical transportation used in thecourse of asthma and allergic rhinitis treatment and indirect costssuch as work and school day losses were evaluated.Results:In terms of demographic characteristics, the two groupshave a similar distribution. In clinical terms, when the scores of thepre‐treatment and the first, second and third years of treatmentwere examined for both the SCIT and the SLIT Group, all three ofthe asthma, rhinitis and drug scores decreased significantly. (for all;P = 0.000).The total cost of 3 years of patients using SCIT was 15665 TL perperson whereas the total cost of 3 years of patients using SLIT was15271 TL per person. When we compare the total cost data of bothgroups, we found that they are close to each other. While the great-est portion of the cost data of patients with SCIT treatment wasdirect costs associated with the treatment itself (72%); The remain-ing part of the total cost was indirect (16%) with non‐medicalexpenses such as transportation (12%). In the SLIT group, directcosts including drug expenditures have a larger percentage (92%)and it was significantly more costly compared to the direct costs ofthe SCIT group (72%). Transportation costs were found to be morecostly in the SCIT group (12%) when compared to the SLIT group(4%). Similarly loss of parent work days in the SCIT group(%16) wasfound to be significantly more expensive compared with SLIT group(4%).Conclusion:Our study results show that SLIT is a similar treatmentfor clinically and laboratorially and has a similar efficacy to SCIT toreduce the patients’complaints and to the need for medication. Forcost‐effectiveness however medicines for treatment of SCIT are lesscostly; when long term total treatment costs are calculated SLIT andSCIT treatment are economically close treatments