A cost-minimization analysis (CMA) was performed to evaluate the economic implications of introducing the SQ Tree sublingual immunotherapy (SLIT)-tablets marketed as ITULATEK® (Health Canada regulatory approval in April 2020) for the treatment of pollen-induced (birch, alder and/or hazel) seasonal allergic rhinitis in Canada (Ontario and Quebec), where Tree Pollen subcutaneous immunotherapy (SCIT) is already an available treatment option. A CMA was deemed appropriate and was based on the assumption that the SQ Tree SLIT-tablets have comparable efficacy to Tree Pollen SCIT. A societal perspective was adopted in the model, including relevant costs of medications, costs of health care services, and productivity losses. The time horizon in the model was three years, which corresponds to a minimal treatment course of allergy immunotherapy. Resource use and costs were based on published sources, where available, and validated by Canadian specialist clinicians (allergists) in active practice in Ontario and in Quebec, where applicable. A discount rate of 1.5% was applied in accordance with the Canadian Agency for Drugs and Technologies in Health (CADTH) guidelines. To assess the robustness of the results, scenario analyses were performed by testing alternative assumptions for selected parameters (e.g., Tree Pollen SCIT resource use, discount rates, number of injections, annual SCIT dosing with maintenance injections, and nurse time support), to evaluate their impact on the results of the analysis. The direct costs, including the drug costs, and physician services costs, for three years of treatment, were similar for both SQ Tree SLIT-tablets vs. Tree Pollen SCIT in both Ontario and Quebec ($2799.01 and $2838.70 vs. $2233.76 and $2266.05 respectively). However, when the indirect costs (including patient’s travel expenses and lost working hours) are included in the model, total savings for the treatment with SQ Tree SLIT-tablets of $1111.79 for Ontario and $1199.87 for Quebec were observed. Scenario analyses were conducted and showed that changes in assumptions continue to result in the savings of SQ Tree SLIT- tablets over Tree Pollen SCIT. The CMA indicates that SQ Tree SLIT-tablets are a cost-minimizing alternative to Tree Pollen SCIT when considered from a societal perspective in Ontario and Quebec.

中文翻译：

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舌下免疫治疗片：加拿大治疗树木花粉引起的季节性过敏性鼻炎的成本最低的替代方案

进行了成本最小化分析 (CMA) 以评估引入 SQ Tree 舌下免疫疗法 (SLIT) 片剂的经济影响，该片剂以 ITULATEK®（加拿大卫生部于 2020 年 4 月获得监管批准）销售，用于治疗花粉诱导的（桦木、桤木和/或榛树）季节性过敏性鼻炎在加拿大（安大略省和魁北克省），树花粉皮下免疫疗法 (SCIT) 已经是一种可用的治疗选择。CMA 被认为是合适的，并且基于 SQ Tree SLIT 片剂具有与 Tree Pollen SCIT 相当的功效的假设。该模型采用了社会视角，包括相关药物成本、医疗保健服务成本和生产力损失。模型中的时间跨度为三年，这对应于过敏免疫疗法的最小疗程。资源使用和成本基于已发布的来源（如果有），并由加拿大专业临床医生（过敏症专家）在安大略省和魁北克省（如适用）的积极实践中进行验证。根据加拿大卫生药物和技术局 (CADTH) 指南，采用了 1.5% 的贴现率。为了评估结果的稳健性，通过测试选定参数的替代假设（例如，树花粉 SCIT 资源使用、贴现率、注射次数、每年 SCIT 剂量与维持注射和护士时间支持）进行情景分析，以评估它们对分析结果的影响。SQ Tree SLIT 片剂与 SQ Tree SLIT 片剂的直接成本（包括药物成本和医生服务成本）在三年治疗中相似。安大略省和魁北克省的树花粉 SCIT（分别为 2799.01 美元和 2838.70 美元与 2233.76 美元和 2266.05 美元）。然而，当模型中包括间接费用（包括患者的旅行费用和损失的工作时间）时，观察到使用 SQ Tree SLIT 片剂治疗安大略省 1111.79 美元和魁北克省 1199.87 美元的总节省。进行了情景分析并表明假设的变化继续导致 SQ Tree SLIT-tables 比 Tree Pollen SCIT 节省。CMA 指出，从安大略和魁北克的社会角度考虑，SQ Tree SLIT 片剂是一种成本最低的树花粉 SCIT 替代品。观察到使用 SQ Tree SLIT 片剂治疗安大略省的总节省为 1111.79 美元，魁北克省为 1199.87 美元。进行了情景分析并表明假设的变化继续导致 SQ Tree SLIT-tables 比 Tree Pollen SCIT 节省。CMA 指出，从安大略和魁北克的社会角度考虑，SQ Tree SLIT 片剂是一种成本最低的树花粉 SCIT 替代品。观察到使用 SQ Tree SLIT 片剂治疗安大略省的总节省为 1111.79 美元，魁北克省为 1199.87 美元。进行了情景分析并表明假设的变化继续导致 SQ Tree SLIT-tables 比 Tree Pollen SCIT 节省。CMA 指出，从安大略和魁北克的社会角度考虑，SQ Tree SLIT 片剂是一种成本最低的树花粉 SCIT 替代品。