The present German guideline on allergen specific immunotherapy (AIT) gives an excellent overview about published clinical trials proving the efficiency of allergen preparations for AIT. From the guideline derived publications are currently used for a debate initiated by the Association of Statutory Health Insurance Physicians about conditions for the eligibility of reimbursement. We strongly oppose this discussion about restrictions for the refund ability of marketable AIT products only based on data about evidence evaluations. It is for the Paul-Ehrlich- Institute to decide on the marketability of drugs inclusively allergen extracts on the base of safety, efficacy and benefit-cost analysis. Here we focus on evidence, efficacy, marketability and refund ability of AIT preparations.