title: Cost of adult chronic rhinosinusitis: A systematic review.
abstract: OBJECTIVE
  The objective of this systematic review was to summarize the literature evaluating the costs associated with the management of adult chronic rhinosinusitis (CRS) using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
  
  
  METHODS
  Two separate authors systematically searched eight commonly used medical databases. Included articles were categorized into seven domains: 1) overall healthcare cost (direct and indirect), 2) resource utilization, 3) medical management strategies, 4) overall procedure cost of endoscopic sinus surgery (ESS), 5) intraoperative technologies, 6) ESS litigation, and 7) CRS diagnostics. To maintain a common currency for comparison, all costs were converted to 2014 United States dollars (USD) using an inflation calculator in September 2014.
  
  
  RESULTS
  Forty-four studies were identified for inclusion. The range for overall CRS-related healthcare costs was $6.9 to $9.9 billion 2014 USD per year. Indirect costs were estimated as $13 billion 2014 USD per year. Annual medication costs prior to ESS ranged between $1,547 and $2,700 2014 USD per patient, with a uniform reduction in costs after ESS. The overall US cost of outpatient ESS ranged from $8,200 to $10,500 2014 USD per case. The overall annual economic burden of CRS in the United States was estimated to be $22 billion 2014 USD (direct and indirect costs).
  
  
  CONCLUSIONS
  The results of this systematic review have demonstrated substantial direct and indirect costs associated with the management of adult CRS. Future research should continue to improve the costing data, which can be used to improve the value of care provided for this chronic inflammatory disease.
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Kristine A
authors: KA
authors: Smith
authors: Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
authors: Richard R
authors: RR
authors: Orlandi
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Luke
authors: L
authors: Rudmik
mesh_terms: D000328:Adult; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D012220:Rhinitis / Q000191:economics*; D012852:Sinusitis / Q000191:economics*; D014481:United States
keywords: Cost-effectiveness; chronic rhinosinusitis; economic evaluation; systematic review