Law Amy W, Reed Shelby D, Sundy John S, Schulman Kevin A
Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, NC 27715, USA.
J Allergy Clin Immunol. 2003 Feb;111(2):296-300. doi: 10.1067/mai.2003.68.
Previous estimates of the cost of allergic rhinitis predate the substantial increase in the use of second-generation antihistamines and intranasal corticosteroids.
We sought to update estimates of the direct costs of allergic rhinitis in the United States and to estimate prescription medication expenditures by type of insurance coverage.
Data from the 1996 Medical Expenditure Panel Survey were used in a cross-sectional analysis of resource use and costs.
Approximately 7.7% of the population are estimated to have had allergic rhinitis in 1996. The total direct medical cost of allergic rhinitis was estimated at $3.4 billion, with the majority attributable to prescription medications (46.6%) and outpatient visits (51.9%). Fifty-one percent of the prescription medication expenditures were for second-generation antihistamines, 25% for intranasal corticosteroids, and 5% for first-generation antihistamines. Fifty-eight percent of patients with allergic rhinitis received 1 or more prescription drugs for its treatment during the study year. Among these patients, mean prescription expenditures were $131 (95% CI, $119-$143), of which $50 (95% CI, $43-$56) were paid out of pocket. The mean prescription medication expenditure was $103 (95% CI, $70-$136) for persons with Medicaid, $155 (95% CI, $140-$169) for private insurance, $213 (95% CI, $0-$521) for other insurance, and $69 (95% CI, $57-$80) for no prescription drug insurance.
The direct costs of allergic rhinitis have increased substantially since the introduction of second-generation antihistamines and intranasal corticosteroids, especially costs attributable to prescription medications. Individuals with no insurance coverage have higher total out-of-pocket prescription expenditures than those with coverage.
先前对过敏性鼻炎成本的估计早于第二代抗组胺药和鼻用糖皮质激素使用的大幅增加。
我们试图更新美国过敏性鼻炎直接成本的估计，并按保险覆盖类型估计处方药支出。
1996年医疗支出小组调查的数据用于资源使用和成本的横断面分析。
据估计，1996年约7.7%的人口患有过敏性鼻炎。过敏性鼻炎的直接医疗总成本估计为34亿美元，其中大部分归因于处方药（46.6%）和门诊就诊（51.9%）。51%的处方药支出用于第二代抗组胺药，25%用于鼻用糖皮质激素，5%用于第一代抗组胺药。58%的过敏性鼻炎患者在研究年度接受了1种或更多处方药治疗。在这些患者中，平均处方支出为131美元（95%可信区间，119 - 143美元），其中50美元（95%可信区间，43 - 56美元）为自付费用。医疗补助计划参保者的平均处方药支出为103美元（95%可信区间，70 - 136美元），私人保险参保者为155美元（95%可信区间，140 - 169美元），其他保险参保者为213美元（95%可信区间，0 - 521美元），无处方药保险者为69美元（95%可信区间，57 - 80美元）。
自第二代抗组胺药和鼻用糖皮质激素问世以来，过敏性鼻炎的直接成本大幅增加，尤其是处方药成本。无保险覆盖的个体自付的处方药总支出高于有保险覆盖的个体。
