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Cost of therapy for allergic rhinitis
Objective:
To describe the cost of medicines used in the treatment of allergic rhinitis in South Africa.
Design:
MIMS was used as the reference for the list of drugs, drug formulation and size, and recommended dosage. These figures were then checked against the package insert of each agent. The cost of each agent was originally derived from the same source, but for standardisation purposes the blue book price was used. Measure of effectiveness was derived from the International Consensus Report on the Diagnosis and Management of Rhinitis. Costs per treatment periods of 10 days (course) and 30 days (month) were calculated. The 'cost' differs from the 'price' in that it takes efficacy into account.
Main Outcome Measures:
Cost of drugs used in the treatment of allergic rhinitis.
Results:
The least costly treatments for allergic rhinitis are the intranasal corticosteroids. Sodium cromoglycate was the most costly, being nearly 20 times more expensive than the nasal steroids. Anticholinergic sprays and topical decongestants were also more costly than nasal steroids, as were the antihistamines. The older-generation antihistamine, ketotifen, was not only more costly than the four oral newer-generation agents in this class but has the added disadvantage of greater sedative side-effects. All oral antihistamines were outclassed by the topical antihistamine, levocabastine.
Conclusions:
This study in no way aims to recommend treatment for allergic rhinitis. However, it highlights the need to consider efficacy of a drug before unit price in the selection of treatment regimens. It is therefore a comment on practical issues in drug selection in the treatment of allergic rhinitis.