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In Sweden, allergy immunotherapy (AIT) is available as either subcutaneous immunotherapy (SCIT) injections or sublingual immunotherapy (SLIT) tablets and is used to treat moderate-severe allergic rhinitis (AR). This study sought to determine treatment-related CO2 emissions and travel times in Swedish patients receiving either SCIT or SLIT-tablets. A list of specialized Swedish AR clinics that administer AIT was determined, and respective co-ordinates retrieved. Swedish municipality population data were obtained from a national database. The mean distance from each Swedish municipality to the nearest AR clinic was calculated, adjusted using a detour index, and weighted by estimated patient population size. Transport modality data were obtained from a Swedish urban transport study and CO2 emissions were obtained from Government sources. The mean number of annual SLIT-tablets and SCIT doses required were calculated based on product labels and clinical expert input. The annual number of healthcare professional interactions were layered into the model to estimate changes in mean patient travel time, distance, and travel-related CO2 emissions associated with using SCIT versus SLIT-tablets. Mean annual travel-related CO2 emissions were 410 tonnes (to two significant figures [s.f.]; standard deviation [SD] 90) with SLIT-tablets, versus 1700 tonnes (SD 380) for SCIT, resulting in mean annual savings of approximately 1300 tonnes (SD 290) of CO2 if all AIT patients were to receive SLIT-tablets instead of SCIT, over 380 times greater than 2021 average Swedish CO2 emissions per capita. Approximate mean annual travel times for patients taking SLIT-tablets were 66,500 h (three s.f.; SD 14,400), and 278,000 h (SD 60,200) for SCIT, resulting in mean annual savings of 211,000 h (SD 45,800) if all AIT patients were to receive SLIT-tablets instead of SCIT. Compared with SCIT injections, SLIT-tablets led to substantial reductions in treatment-related CO2 emissions and travel times for Swedish patients. [ABSTRACT FROM AUTHOR]

This paper studies intertemporal changes in the value of travel time (VTT) and investigates whether the change of VTT over time can be studied based on national VTT data, collected at two points in time. We use repeated national VTT data from the Netherlands and Sweden, collected 13 and 14 years apart. The results show mostly a declining VTT for a given income level. The results show also a large within-country heterogeneity across modes and purposes, in the cross-sectional income elasticity of the VTT, and in its development over time. The explanation most consistent with our results and those of others is that the VTT has in fact increased due to income increases, but that the repeated stated choice data cannot detect this given the data, methodology and population changes. In particular, it seems that the response rate has dropped considerably in the later surveys partly due to a higher share of (busy) respondents declining to be recruited. The main contribution of this paper is to document the differences between the studies carried out in different years, indicating the reasons why it is difficult to identify temporal changes in the VTT. [ABSTRACT FROM AUTHOR]