The economic impact of allergic rhinitis and current guidelines for treatment

https://doi.org/10.1016/j.anai.2010.10.014Get rights and content

Objective

To describe the economic burden of allergic rhinitis treatment and current guidelines for treatment.

Data Sources

Review articles and original research were retrieved from MEDLINE, OVID, PubMed (1950-November 2009), personal files of articles, and bibliographies of located articles that addressed the topic of interest.

Study Selection

Articles were selected for their relevance to the burden of allergic rhinitis and current guidelines for treatment. Publications included reviews, treatment guidelines, and clinical studies.

Results

Despite the common symptoms of allergic rhinitis, its impact on patient quality of life, and the huge cost to society and individuals of treatment, including pharmacotherapy, many patients do not adhere to their medication regimens because the medications do not adequately address their symptoms or are otherwise problematic for them to use.

Conclusions

The economic impact of allergic rhinitis is substantial; the total direct medical cost of allergic rhinitis is approximately $3.4 billion, with almost half of this cost attributable to prescription medications. Multiple treatment options are available, and these were reviewed to provide an update on effectiveness and adverse effects that may affect patient adherence.

Introduction

The National Jewish Health Symposium entitled Rethinking the Treatment of Allergic Rhinitis; the Role of Intranasal Antihistamines: “Me-Too” Drugs or a Novel Class? was held in Denver, Colorado, on October 8, 2009. This article discusses two of the symposium topics: the economic impact of treating allergic rhinitis and the current guideline recommendations for therapy.

Section snippets

Economic impact of allergic rhinitis treatment

The Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Practice Parameter1 defines rhinitis as “a condition characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching.” Symptoms of rhinitis may occur only during specific seasons, perennially with or without seasonal exacerbation, or episodically after specific aeroallergen exposures. The severity of allergic rhinitis ranges from mild and intermittent to severe and

Current guideline recommendations for therapy for allergic rhinitis

The National Jewish Health symposium faculty reviewed two current guidelines for allergic rhinitis treatment: (1) The Diagnosis and Management of Rhinitis: An Updated Practice Parameter1 from the US-based task force and (2) Allergic Rhinitis and Its Impact on Asthma (ARIA) 2008 Update12 from the group convened by the World Health Organization.

The ARIA guidelines propose a severity classification that is divided into mild or moderate/severe and also a duration classification of intermittent or

Conclusion

The total direct medical cost of allergic rhinitis is approximately $3.4 billion, with nearly half attributable to prescription medications. Patients do not adhere to their medication regimens because of lack of symptoms, they consider the medications ineffective, they feel the medications lose effectiveness over time, they find the medications inconvenient, they find the medications costly, or they are concerned about safety or adverse effects.22, 23 The National Jewish Health panel presented

Acknowledgments

We thank Meda Pharmaceuticals for providing the funding for this research, National Jewish Health for hosting the panel and coordinating publication efforts, Dr Deborah Wilkerson of OmniaVincit LLC for her assistance in writing this article, and Mary E. King, PhD, for editorial assistance.

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    Disclosures: Dr Meltzer serves as a consultant to Abbott, Alcon, Amgen, AstraZeneca, Boehringer Ingelheim, Capnia, Genentech, GlaxoSmithKline, Greer, Ista, Johnson & Johnson, MAP Pharmaceuticals, Meda, Merck, Novartis, Sanofi-Aventis, Schering-Plough, Sepracor, Teva, and Wyeth; serves as a speaker to AstraZeneca, Alcon, AstraZeneca, Genentech, GlaxoSmithKline, Meda, Merck, Sanofi-Aventis, Schering-Plough, and Sepracor; and receives grant/research support from Alcon, Amgen, Alexza, Astellas, AstraZeneca, Boehringer Ingelheim, Capnia, Genentech, GlaxoSmithKline, MAP Pharmaceuticals, Meda, Merck, Novartis, Sanofi-Aventis, Schering-Plough, Sepracor, and Teva. Dr Bukstein has served as a speaker/consultant/advisor for Merck, Genentech, Novartis Pharmaceuticals, Schering-Plough, 3M Pharmaceuticals, Abbott Laboratories, Sanofi-Aventis, Astra-Zeneca, Critical Therapeutics, Aerocrine, Teva, and King Pharmaceuticals; has received research support from Merck, Astra-Zeneca, Sanofi-Aventis, and Merck; and has commercial interests with HealthyAirways LLC, Strategic Pharmaceutical Advisors, and the PBL Institute. Dr. Wilkerson has not served as a consultant or speaker for any allergy or asthma pharmaceutical company.

    Funding Sources: This consensus panel received a grant from Meda Pharmaceuticals to explore the role of intranasal antihistamines in the treatment of allergic rhinitis.

    Requests for reprints should be addressed to: Office of Professional Education, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA, Email: [email protected]

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