Willingness to pay for allergy-vaccination among Danish patients with respiratory allergy.

OBJECTIVE: The aim of this study was to elicit willingness to pay (WTP) for allergen-specific subcutaneous injection immunotherapy (SCIT) in a cohort of respondents suffering from allergic-rhinoconjunctivitis (a-RC)/asthma, and to investigate how patients self-select to SCIT according to need. METHODS: A random sample of the general population was screened for a-RC/asthma and asked if they were willing to consider SCIT. They were asked to state their WTP for SCIT by way of a discrete choice question (DC-q), an open-ended WTP question (o-WTP-q), and questions relating to their sociodemographic background and the severity of their a-RC/asthma. The characteristics of respondents demanding SCIT were compared with the characteristics of respondents who have actually received SCIT to establish possible barriers to demand. RESULTS: Our results suggest that respondents do well in self-selecting themselves to SCIT on the basis of need according to disease burden measured in terms of a-RC classification, number of contacts with a general practitioner, number of sick days, and potential quality-adjusted life-year loss. Mean WTP for SCIT was estimated at 655 euros (median, 267 euros) (o-WTP-q) and 903 euros (95 percent confidence limit, 348-1,459) (DC-q). CONCLUSION: Characteristics of respondents, who consider SCIT and are willing to pay for SCIT, suggest that allergy sufferers select themselves appropriately according to need and not according to other characteristics, such as income or education. There is a significant discrepancy between those who hypothetically consider SCIT and those demanding SCIT in real life. This study suggests that there are barriers to entry related to age and education, but not to income.

Determination of adsorbed protein concentration in aluminum hydroxide suspensions by near-infrared transmittance spectroscopy.

Analysis of aluminum hydroxide based vaccines is difficult after antigen adsorption. Adsorbed protein is often assessed by measuring residual unadsorbed protein for quality control. A new method for the direct determination of adsorbed protein concentration in suspension using near-infrared (NIR) transmittance spectroscopy is proposed here. A simple adsorption system using albumin from bovine serum (BSA) and aluminum hydroxide as a model system is employed. The results show that the NIR absorbance at 700-1300 nm is correlated to the adsorbed BSA concentration, measured by the ultraviolet (UV) method, using the partial least square regression (PLSR) method to construct a calibration model. The linear concentration range of adsorbed BSA is from 0 to 1.75 mg/mL by using 10 mm path length cuvettes. The influence of the sedimentation in suspension, different buffers, and different aluminum hydroxide batches was investigated in this study. It shows that the batch variation is the main influence factor of this method, while the buffer variation has no influence. However, the pretreatment of spectral data by subtracting spectra of BSA blank control (aluminum hydroxide without BSA) can significantly reduce the batch influence, and the NIR predicted results show good agreement with the reference values. The NIR method might be the only direct method for the determination of adsorbed protein concentration in suspension so far. It is a nondestructive method, and it has great advantage for use in vaccine production as a method for quality control and quality assurance.

Determination of moisture content of lyophilized allergen vaccines by NIR spectroscopy.

Moisture content is an important parameter for lyophilized vaccines. Currently, Karl Fischer titration is widely used for moisture determination in routine analysis. However, this method is time-consuming, sample destructive and requires environment polluting reagents, as well as the results rely on the random samplings. In this study, near infrared spectroscopy was used as a fast, non-invasive and non-destructive method to determine the moisture content in lyophilized allergy vaccines. Five different vaccine products were investigated, which contained water in the range of 0.17-1.51% (w/w, KF). Different data pre-treatments, wavelength selection and partial least squares regression were applied to construct calibration models. Multi-products model and product-specific models were obtained, which show the possibility of NIR as a rapid method to discriminate whether moisture content fit into the specifications of a pharmaceutical company.

Particle size determination in aluminum hydroxide suspensions using near-infrared transmittance spectroscopy.

A new method for particle size determination in polystyrene and aluminum hydroxide suspensions using near-infrared transmittance spectroscopy is described. Mono-dispersed polystyrene particle size standards were used to establish the calibration model. The particle sizes used in the study are similar to the wavelength range of 700-1300 nm, where light scattering is wavelength dependent. The wavelength dependency of near-infrared (NIR) absorbance is found to be linear with the particle size when the analysis is based on the same spectrum starting point (the same absorbance at 700 nm). Partial least squares regression (PLSR) is applied to model this linear relationship. Compared to laser diffraction (LD) the NIR method has similar accuracy and precision in the measurement of particles with a uniform size. For a sample containing multiple sizes of particles, the mean size measured by the NIR method is shown to be weighted by the particle mass. The application of the model to aluminum hydroxide suspension shows that the NIR method is suitable for the detection of particle size changes during the production process and storage. The advantages of the NIR method are that no knowledge of the refractive index and the concentration of a sample are necessary and that the method is fast and easy to operate.

Characterization and standardization of allergen extracts.

This paper summarizes the development of the extraction and characterization of allergens responsible for the induction of immunoglobulin (lg) E-induced allergies from the beginning of the 20th century, including the nomenclature of allergens. The majority of papers characterizing allergens and allergen extracts state that the lack of standardization of allergen extracts is the reason for the paper, and so it has been for more than 100 years. A natural part of that process might be the isolation of an allergen molecule and this starts the speculation of 'what makes that allergen an allergen?' To achieve the perfect standardization is a desirable end that is still awaited. So far none of these problems have been finally solved. I started in allergy shortly after the discovery of IgE in 1967. Since that time the history as I remember it is based on the literature, my interpretation of it, and of course may be a little biased due to personal prejudice! The history of the last 10-15 years has still not matured and it might be a little early to draw conclusions. However, at the end of this chapter I do dare to make a few conclusions after having followed the development in this field for 40 years. As this is history it is not meant to be either comprehensive or technically and scientifically precise in all aspects, but rather draws on some thoughts as to what in my mind have been important developments until now. Specific techniques are only mentioned by name and not intended to be discussed in depth. This activity has, however, pushed me to reflect on my hopes and speculations at the time of my introduction to the field of allergen chemistry. To my surprise I realize that far more than I ever expected at that time has been fulfilled. It has been extremely exciting to be a part of that development.

Determination of aluminium content in aluminium hydroxide formulation by FT-NIR transmittance spectroscopy.

A method for determining the aluminium content of an aluminium hydroxide suspension using near infrared (NIR) transmittance spectroscopy has been developed. Inductively coupled plasma-atomic emission spectroscopy (ICP-AES) was used as reference method. The factors influencing the NIR analysis, such as different sample containers (transmission cell and cuvette), sedimentation in the suspension, day-to-day variation and batch-to-batch variation have been studied before constructing a calibration model. Seven dilutions (0-4100 mg Al/L) of five batches of aluminium hydroxide suspension samples were measured by NIR transmission each on five different days, with total of 175 spectra used for the calibration set. The multivariate data analysis technique partial least square regression (PLSR) was applied to build the calibration model. Six batches of aluminium hydroxide samples were used for the test set. ICP-AES and NIR transmittance spectroscopy exhibit comparable precision and accuracy. The NIR method provides several advantages: no complicated sample preparation; easy to operate; fast and non-destructive. In conclusion, NIR transmittance spectroscopy can be an alternative analytical method for determining aluminium content in aluminium hydroxide suspension.