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Costs of second-generation antihistamines in the treatment of allergic rhinitis: US perspective
Current Medical Research and Opinion, 06/26/09

Hay JW et al. - Preliminary evidence suggests that newer SGAs offer clinical, pharmacodynamic, and pharmacokinetic advantages that may translate into superior cost-effectiveness in the treatment of AR. Further study is warranted to clarify the pharmacoeconomic impact of the newer SGAs and to establish their relative cost-effectiveness.

Exclusive Author Commentary
Joel W. Hay, 07/13/09

The direct costs associated with allergic rhinitis (AR) exceeded $11 billion in 2005, with nearly 60% of the total expenditure spent on prescription medications. The majority of individuals with AR in the U.S. are treated with antihistamines; approximately two thirds of those use first-generation antihistamines (FGAs) and one third uses second-generation antihistamines (SGAs). Although less expensive per unit use, FGAs may actually result in increased overall medical expenditures compared with SGAs owing to lost productivity and increased emergency department visits related to adverse events. Our recent literature review demonstrates that SGAs offer clinical, pharmacodynamic, and pharmacokinetic advantages that may translate into greater cost-effectiveness in the treatment of AR. Further study is warranted to clarify the pharmacoeconomic impact of SGAs and to establish their relative cost-effectiveness over FGAs. Current managed care policies that restrict the use of prescription vs. over-the-counter SGAs should be reexamined for cost-effectiveness.

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