A descriptive analysis of the use and cost of new-generation antihistamines in the treatment of allergic rhinitis: a retrospective database analysis.
OBJECTIVE
This retrospective database analysis was conducted to evaluate the use and cost of new-generation antihistamines (i.e., those that are nonsedating) in the treatment of allergic rhinitis in a managed care population.


METHODS
The study is a retrospective database review of medical and pharmacy-related claims linked by episodes of care.


METHODS
Patients who had been diagnosed as having allergic rhinitis and had at least 1 prescription claim were identified from a database containing patient-level medical and pharmacy-related claims. The treatment patterns of patients with allergic rhinitis who met the study criteria were documented for a 12-month period in which the use of nonsedating antihistamines was described and the associated costs of various medications were assessed. Subanalyses of patients categorized by comorbidity status were also performed.


RESULTS
A total of 202,426 patients participated in the study. Nonsedating antihistamines were used by 71% of the patients; the most commonly prescribed drugs were loratadine and fexofenadine. The mean annual charges per patient for the treatment of allergic rhinitis in the study population were $465.21 (standard deviation [SD], 548). The greatest departmental cost was that of pharmacy-related charges (mean, $236.02; SD, 233); the next highest cost was that of outpatient charges (mean, $216.31; SD, 396). Comparisons of departmental charges indicated the use of loratadine was associated with significantly higher treatment costs than that of fexofenadine in a number of patient subgroups.


CONCLUSIONS
In this analysis, loratadine was associated with significantly higher treatment charges than was fexofenadine. This result was observed consistently across different stratifications of patients, including the presence of comorbid respiratory infection, concomitant use of nasal steroids, and the presence of asthma and/or sinusitis. These results provided useful insights into the differential costs associated with the use of nonsedating antihistamines in the treatment of rhinitis.
Lee
J
J
Cummins
G
G
Okamoto
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000191:economics* / Q000627:therapeutic use*; D017332:Cetirizine / Q000191:economics / Q000627:therapeutic use; D002648:Child; D019992:Databases as Topic; D017723:Drug Utilization Review; D005260:Female; D006634:Histamine H1 Antagonists / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D017336:Loratadine / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D016593:Terfenadine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D014481:United States
D018926:Anti-Allergic Agents; D006634:Histamine H1 Antagonists; D017336:Loratadine; D016593:Terfenadine; C093230:fexofenadine; D017332:Cetirizine