title: Estimate of the total costs of allergic rhinitis in specialized care based on real-world data: the FERIN Study.
abstract: BACKGROUND
  Despite the socioeconomic importance of allergic rhinitis (AR), very few prospective studies have been performed under conditions of clinical practice and with a sufficiently long observation period outside the clinical trial scenario. We prospectively estimated the direct and indirect costs of AR in patients attending specialized clinics in Spain.
  
  
  METHODS
  Patients were recruited at random from allergy outpatient clinics in 101 health centers throughout Spain over 12 months. We performed a multicenter, observational, prospective study under conditions of clinical practice. We analyzed direct costs from a funder perspective (healthcare costs) and from a societal perspective (healthcare and non-healthcare costs). Indirect costs (absenteeism and presenteeism [productivity lost in the workplace]) were also calculated. The cost of treating conjunctivitis was evaluated alongside that of AR.
  
  
  RESULTS
  The total mean cost of AR per patient-year (n = 498) was €2326.70 (direct, €553.80; indirect, €1772.90). Direct costs were significantly higher in women (€600.34 vs €484.46, P = 0.02). Total costs for intermittent AR were significantly lower than for persistent AR (€1484.98 vs €2655.86, P < 0.001). Total indirect costs reached €1772.90 (presenteeism, €1682.71; absenteeism, €90.19). The direct costs of AR in patients with intermittent asthma (€507.35) were lower than in patients with mild-persistent asthma (€719.07) and moderate-persistent asthma (€798.71) (P = 0.006).
  
  
  CONCLUSIONS
  The total cost of AR for society is considerable. Greater frequency of symptoms and more severe AR are associated with higher costs. Indirect costs are almost threefold direct costs, especially in presenteeism. A reduction in presenteeism would generate considerable savings for society.
authors.affiliation: Department of Allergology, Hospital Clínico-Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Colás
authors.affiliation: Oblikue Consulting, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Brosa
authors.affiliation: Department of Allergology, University Hospital Marqués de Valdecilla, Santander, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Antón
authors.affiliation: Allergy Unit, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Montoro
authors.affiliation: UGC Intercentros Alergología de Sevilla, Hospital El Tomillar, Sevilla, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Navarro
authors.affiliation: Department of Allergology, Hospital Municipal, Badalona Serveis Assistencials, Badalona, Spain.|Sant Pere Claver Fundació Sanitària, Barcelona, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: Dordal
authors.affiliation: Department of Allergology, University Hospital of Salamanca, Instituto de Investigaciones Biosanitarias de Salamanca, IBSAL, Salamanca, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Dávila
authors.affiliation: Department of Allergology, Hospital El Bierzo, Ponferrada, León, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Fernández-Parra
authors.affiliation: Department of Allergology, Hospital Infantil Universitario Niño Jesús, IIS Princesa, Madrid, Spain.
authors.forename: M D P
authors.initials: MDP
authors.lastname: Ibáñez
authors.affiliation: Department of Allergology, Hospital La Paz, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Lluch-Bernal
authors.affiliation: Department of Allergology, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Matheu
authors.affiliation: Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Rondón
authors.affiliation: UGC Neumología-Alergia, Complejo Hospitalario Universitario de Huelva, Spain.
authors.forename: M C
authors.initials: MC
authors.lastname: Sánchez
authors.affiliation: Allergy Unit, Servei de Pneumologia i Al.lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona, Spain.|Centro de Investigación Biomédica en red en Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Valero
mesh_terms: D000041:Absenteeism; D017281:Cost of Illness; D017048:Health Care Costs; D006801:Humans; D000069597:Presenteeism / Q000191:economics; D011446:Prospective Studies; D065631:Rhinitis, Allergic / Q000191:economics*; D013030:Spain
keywords: allergic; healthcare costs; observational study; prospective study; rhinitis