title: Costs of perennial allergic rhinitis and allergic asthma increase with severity and poor disease control.
abstract: BACKGROUND
  Perennial allergic rhinitis (PAR) represents a global and public health problem, due to its prevalence, morbidity, and impact on the quality of life. PAR is frequently associated with allergic asthma (AA). Costs of PAR with or without AA are poorly documented.
  
  
  OBJECTIVE
  Our study aimed to detail medical resource utilization (MRU) and related direct cost for PAR, with or without concomitant AA, in France.
  
  
  METHODS
  Using Electronic Health Records (EHRs), we identified in 2010 two cohorts of PAR patients, based on General Practitioners' diagnoses and prescribing data, with and without concomitant AA. For each patient, the EHRs were linked to corresponding claims data with MRU and costs during years 2011 to 2013. Predefined subgroup analyses were performed according to severity of PAR and level of AA control.
  
  
  RESULTS
  The median annual cost reimbursed by social security system for a patient with PAR, and no AA was 159€ in 2013. This varied from 111€ to 188€ depending on PAR severity. For patients with PAR and concomitant AA, the median annual cost varied between 266€ and 375€, and drug treatment accounted for 42-55% of the costs, depending on asthma control.
  
  
  CONCLUSIONS
  This study linking diagnoses from EHRs to claims data collected valid information on PAR management, with or without concomitant AA, and on related costs. There was a clear increase in costs with severity of PAR and control of AA.
authors.affiliation: HESPER 7425, Health Services and Performance Research, University Claude Bernard Lyon 1, Lyon, France.|PELyon, PharmacoEpidemiologie Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Belhassen
authors.affiliation: Department of Pulmonology, Division of Allergy, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France.|Sorbonne University, UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, EPAR, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Demoly
authors.affiliation: French Association for Continual Medical Education of Allergists (ANAFORCAL), Reims, France.
authors.forename: E
authors.initials: E
authors.lastname: Bloch-Morot
authors.affiliation: ESSEC Business School, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: de Pouvourville
authors.affiliation: HESPER 7425, Health Services and Performance Research, University Claude Bernard Lyon 1, Lyon, France.|PELyon, PharmacoEpidemiologie Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Ginoux
authors.affiliation: ALK ABELLO, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Chartier
authors.affiliation: HESPER 7425, Health Services and Performance Research, University Claude Bernard Lyon 1, Lyon, France.|PELyon, PharmacoEpidemiologie Lyon, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Laforest
authors.affiliation: ALK ABELLO, Copenhagen, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Serup-Hansen
authors.affiliation: IMS HEALTH, Courbevoie, France.
authors.forename: M
authors.initials: M
authors.lastname: Toussi
authors.affiliation: HESPER 7425, Health Services and Performance Research, University Claude Bernard Lyon 1, Lyon, France.|PELyon, PharmacoEpidemiologie Lyon, Lyon, France.|Respiratory Medicine, Croix Rousse University Hospital, Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Van Ganse
mesh_terms: D001249:Asthma / Q000188:drug therapy / Q000191:economics*; D015897:Comorbidity; D016527:Drug Costs; D005602:France; D017048:Health Care Costs; D006801:Humans; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000191:economics*; D012943:Social Security
keywords: allergic asthma; control; costs; medical resource utilization; perennial allergic rhinitis