Betula verrucosa can be used as an option to treat moderate to severe allergic rhinitis or conjunctivitis caused by pollen from the birch homologous group of trees in adults with:
symptoms despite using symptom-relieving medicines
a positive sensitisation test (skin prick test or specific immunoglobulin E) to a member of the birch homologous group.
What this means in practice
Betula verrucosa must be funded in the NHS in England for the condition and population in the recommendation, if it is considered the most suitable treatment option. Betula verrucosa must be funded in England within 90 days of final publication of this guidance.
There is enough evidence to show that betula verrucosa provides benefits and value for money, so it can be used routinely across the NHS in this population.
NICE has produced tools and resources to support the implementation of this guidance.
For this evaluation, betula verrucosa was considered only for use in adults. This does not include everyone who it is licensed for.
Usual treatment for moderate to severe allergic rhinitis and conjunctivitis caused by pollen from the birch homologous group of trees includes symptom-relieving medicines such as antihistamine tablets and corticosteroid nasal sprays.
Clinical trial evidence shows that betula verrucosa reduces the severity of allergic rhinitis and conjunctivitis symptoms compared with placebo (both when given with symptom-relieving medicines).
There is uncertainty in the economic model about how many healthcare appointments would be saved by using betula verrucosa. But even when taking this into account, the likely cost-effectiveness estimates are all within the range that NICE considers an acceptable use of NHS resources. So, betula verrucosa can be used.
For all the evidence, see the committee papers. For more information on streamlined evaluations, see NICE's manual on health technology evaluations.