Direct costs of allergic rhinitis in the United States: estimates from the 1996 Medical Expenditure Panel Survey.
BACKGROUND
Previous estimates of the cost of allergic rhinitis predate the substantial increase in the use of second-generation antihistamines and intranasal corticosteroids.


OBJECTIVE
We sought to update estimates of the direct costs of allergic rhinitis in the United States and to estimate prescription medication expenditures by type of insurance coverage.


METHODS
Data from the 1996 Medical Expenditure Panel Survey were used in a cross-sectional analysis of resource use and costs.


RESULTS
Approximately 7.7% of the population are estimated to have had allergic rhinitis in 1996. The total direct medical cost of allergic rhinitis was estimated at $3.4 billion, with the majority attributable to prescription medications (46.6%) and outpatient visits (51.9%). Fifty-one percent of the prescription medication expenditures were for second-generation antihistamines, 25% for intranasal corticosteroids, and 5% for first-generation antihistamines. Fifty-eight percent of patients with allergic rhinitis received 1 or more prescription drugs for its treatment during the study year. Among these patients, mean prescription expenditures were $131 (95% CI, $119-$143), of which $50 (95% CI, $43-$56) were paid out of pocket. The mean prescription medication expenditure was $103 (95% CI, $70-$136) for persons with Medicaid, $155 (95% CI, $140-$169) for private insurance, $213 (95% CI, $0-$521) for other insurance, and $69 (95% CI, $57-$80) for no prescription drug insurance.


CONCLUSIONS
The direct costs of allergic rhinitis have increased substantially since the introduction of second-generation antihistamines and intranasal corticosteroids, especially costs attributable to prescription medications. Individuals with no insurance coverage have higher total out-of-pocket prescription expenditures than those with coverage.
Law
Amy W
AW
Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, NC 27715, USA.
Reed
Shelby D
SD
Sundy
John S
JS
Schulman
Kevin A
KA
D000553:Ambulatory Care / Q000191:economics; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003625:Data Collection; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000191:economics*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000191:economics*; D014481:United States