title: Cost-effectiveness of second-generation antihistamines and montelukast in relieving allergic rhinitis nasal symptoms.
abstract: OBJECTIVE
  Allergic rhinitis imposes a significant health and economic burden both on individuals and the healthcare system. Second-generation prescription antihistamines, levocetirizine, fexofenadine, and desloratadine, and the leukotriene receptor antagonist, montelukast, differ in their ability to relieve common rhinitis symptoms. The purpose of this study was to compare the cost-effectiveness of prescription agents based on their effectiveness in relieving nasal symptoms.
  
  
  METHODS
  Effectiveness was measured as the composite of nasal symptoms, including congestion, rhinorrhea, and sneezing, from clinical studies that compared each of the 4 comparators to placebo. Direct costs included prescription therapy and rhinitis-related physician office visits. Physician office visit costs were collected from an analysis of the PharMetrics insurance claims database. Sensitivity analyses were conducted using a Monte Carlo simulation to assess the robustness of the average and incremental cost-effectiveness ratios.
  
  
  RESULTS
  The cost per clinically significant improvement of nasal symptoms for levocetirizine was less than for the other model comparator agents. The incremental cost-effectiveness ratio for levocetirizine dominated montelukast and desloratadine and was lower than either branded or generic fexofenadine.
  
  
  CONCLUSIONS
  Levocetirizine is a cost-effective therapy for the relief of nasal symptoms of allergic rhinitis.
authors.affiliation: Director, Xcenda, Palm Harbor, FL.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goodman
authors.affiliation: Manager, Health Outcomes, sanofi-aventis, Bridgewater, NJ.
authors.forename: Mehul
authors.initials: M
authors.lastname: Jhaveri
authors.affiliation: PhD student in Pharmaceutical Economics, Policy, and Outcomes, University of Arizona College of Pharmacy, Tucson, AZ, and an analyst, Xcenda, Palm Harbor, FL.
authors.forename: Kim
authors.initials: K
authors.lastname: Saverno
authors.affiliation: Associate Director, Xcenda, Palm Harbor, FL.
authors.forename: Kellie
authors.initials: K
authors.lastname: Meyer
authors.affiliation: Vice President, Xcenda, Palm Harbor, FL.
authors.forename: Brian
authors.initials: B
authors.lastname: Nightengale