title: TOTALL: high cost of allergic rhinitis-a national Swedish population-based questionnaire study.
abstract: Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18-65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society.
authors: Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.|Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors: Lars-Olaf
authors: LO
authors: Cardell
authors: Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors: Petter
authors: P
authors: Olsson
authors: Department of Otorhinolaryngology, Skåne University Hospital, Lund, Sweden.
authors: Morgan
authors: M
authors: Andersson
authors: The Swedish Institute for Health Economics (IHE), Lund, Sweden.
authors: Karl-Olof
authors: KO
authors: Welin
authors: The Swedish Institute for Health Economics (IHE), Lund, Sweden.
authors: Johanna
authors: J
authors: Svensson
authors: The Swedish Institute for Health Economics (IHE), Lund, Sweden.
authors: Gunnel Ragnarson
authors: GR
authors: Tennvall
authors: Department of Ear, Nose and Throat Diseases, Head &Neck Surgery, Institute of Clinical Science, Gothenburg University, Gothenburg, Sweden.
authors: Johan
authors: J
authors: Hellgren
mesh_terms: D000041:Absenteeism; D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003888:Desensitization, Immunologic / Q000191:economics; D016527:Drug Costs; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006633:Histamine Antagonists / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000191:economics / Q000627:therapeutic use; D000069597:Presenteeism / Q000191:economics*; D065631:Rhinitis, Allergic / Q000188:drug therapy / Q000191:economics*; D011795:Surveys and Questionnaires; D013548:Sweden; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists; D014663:Nasal Decongestants