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.

Estimate of the total costs of allergic rhinitis in specialized care based on real‐world data: the FERIN Study

“…At least one similar published study analyzed seasonal AR in a small sample over a 6‐month period, although it only took into account direct costs . Cardell et al recently provided a more general perspective of the magnitude of the social burden of AR. Prospective studies lasting ≥6 months have been performed in the trial setting , although the therapeutic options are very limited and do not reflect current practice.…”

Intralymphatic Immunotherapy: Update and Unmet Needs

“…With only 3 injections with 1-month time intervals, and therefore a treatment duration of merely 2 months, the inconvenience for the patient and the overhead for the clinical practice is considerably lower than with up to 70 practice visits for injections over up to 5 years for the gold standard SCIT, thus enhancing treatment adherence. The health economic impact [33, 34] of ILIT may be substantial due to reduced consumption of resources during treatment, but also, when successful, due to reduced use of rescue medication for symptomatic treatment and fewer sick leaves.…”

Rhinitis, not to sniff at

“…Already for years we have ample evidence of the severe impact of allergic and non-allergic rhinitis and maybe even more rhinosinusitis on quality of life of our patients and the severe costs these diseases inflict on society (1)(2)(3)(4) .…”