title: Economic burden of rhinitis in managed care: a retrospective claims data analysis.
abstract: BACKGROUND
  Little is known about the specific cost effect of rhinitis on third-party payers. No recently reported studies have examined the economic burden of rhinitis in managed care. Furthermore, the direct costs of chronic rhinitis have not been evaluated and potential differences in health care use and costs of allergic rhinitis have not been examined.
  
  
  OBJECTIVE
  To evaluate the economic burden of allergic rhinitis and chronic rhinitis to third-party payers in a large US managed care plan.
  
  
  METHODS
  In a retrospective analysis using pharmacy and medical claims data from a US health plan covering approximately 15 million members, health care use and cost data were summarized for patients with allergic or chronic rhinitis (n = 301,001) for the 13-month study period (January 1, 2004, to January 31, 2005).
  
  
  RESULTS
  Average rhinitis-related total costs were $657 per patient each year ($319 in medical costs and $338 in pharmacy costs). Ambulatory visits were the primary contributor to rhinitis-related medical costs. Antihistamines were the most common rhinitis medication, followed by intranasal corticosteroids (INSs) and montelukast. Many patients (37% with at least 1 filled prescription for an antihistamine, an INS, or montelukast) used combination therapy. Of the 3 main pharmacotherapy categories, montelukast was associated with the highest pharmacy cost ($353 vs $198 for antihistamines and $231 for INSs per patient each year for monotherapy) and drove the average annual cost of combination therapy regardless of the concomitant medication(s). The most common comorbidities were sinusitis and asthma, present in 51.1% and 27.9% of patients, respectively. Comorbidities increased rhinitis-related health care costs.
  
  
  CONCLUSIONS
  Allergic rhinitis and chronic rhinitis imposed a significant financial burden on third-party payers in a large US managed care plan. The presence of comorbidities further increased the rhinitis-related treatment costs.
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina, USA. anand.a.dalal@gsk.com
authors.forename: Anand A
authors.initials: AA
authors.lastname: Dalal
authors.forename: Richard
authors.initials: R
authors.lastname: Stanford
authors.forename: Henk
authors.initials: H
authors.lastname: Henry
authors.forename: Bijan
authors.initials: B
authors.lastname: Borah
mesh_terms: D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000191:economics*; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006967:Hypersensitivity / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D012189:Retrospective Studies; D012220:Rhinitis / Q000191:economics* / Q000276:immunology
chemical_list: D018926:Anti-Allergic Agents