Background Allergy immunotherapy is an effective treatment for patients with
allergic rhinitis whose symptoms are unresolved with pharmacotherapy. Allergy
immunotherapy for grass pollen-induced allergic rhinitis is available in three
modalities: subcutaneous immunotherapy and sublingual immunotherapy as a
tablet or drop. This study aimed to understand trends in allergy immunotherapy
prescribing and practice patterns for grass allergies in adult and paediatric
patients in Germany. Methods A retrospective cohort study was conducted using
IMS Disease Analyzer in Germany. Patients with an allergy immunotherapy
prescription for grass pollen (Anatomical Therapeutic Chemical [ATC]
classification code V01AA02) from September 2005 to December 2012 were
included in the study. General Practitioners (GPs), dermatologists, Ear, Nose
and Throat (ENT)-specialists, paediatricians and pneumologists were included
as the allergy immunotherapy prescribing physicians in the study. Descriptive
analyses were conducted on patient characteristics at index and prescribing
physician specialty; a test for trend was conducted for timing of initiation
of first allergy immunotherapy prescription in each annual prescribing season.
Results Eighteen thousand eight hundred fifty eligible patients were
identified during the study period. The majority of patients received
subcutaneous immunotherapy; however, the proportion of patients receiving
sublingual immunotherapy tablets increased from 8 % in 2006/2007 to 29 % in
2011/2012 (p < 0.001). Initiation of subcutaneous immunotherapy and Oralair®
generally peaked during each prescribing year in two seasons (September-
October and January) while GRAZAX® prescriptions peaked in autumn (September-
October). ENT-specialists and dermatologists were the largest allergy
immunotherapy prescribers in adults, while paediatricians and ENT-specialists
were the largest prescribers of allergy immunotherapy in paediatric patients.
Conclusions Subcutaneous immunotherapy remained the dominant allergy
immunotherapy modality for grass pollen-induced allergic rhinitis in Germany
for adult and paediatric patients; however, there was a marked increase in
proportion of patients receiving sublingual immunotherapy tablets from
2006/2007 to 2011/2012, after their introduction to the market in 2006. ENT-
specialists, dermatologists and paediatricians were responsible for the
majority of prescribing. The predominance of particular modalities within
certain physician specialties likely reflects different treatment goals or
needs