Estimation of Health and Economic Benefits of Commercial Peanut Immunotherapy Products

Key Points Question Epicutaneous peanut immunotherapy and peanut oral immunotherapy may be approved in 2019 or 2020, but what variables will determine if these therapies will be cost-effective? Findings This economic evaluation estimated a ceiling value-based cost (willingness-to-pay threshold $100 000 per quality-adjusted life-year) between $1568 and $6568 for epicutaneous peanut immunotherapy and between $1235 and $5235 for peanut oral immunotherapy. Cost-effectiveness of both therapies was sensitive to rates of sustained unresponsiveness, improvements in health state utility, and risk reduction of anaphylaxis. Meaning Cost-effectiveness of epicutaneous peanut immunotherapy and peanut oral immunotherapy will be heavily influenced by their probability of sustained unresponsiveness, improvement in quality of life, risk reduction of anaphylaxis, and cost to patient.