A descriptive analysis of the use and cost of new-generation antihistamines in the treatment of allergic rhinitis: A retrospective database analysis

Objective: This retrospective database analysis was conducted to evaluate t he use and cost of new-generation antihistamines tie, those that are nonsed ating) in the treatment of allergic rhinitis in a managed care population. Study Design: The study is a retrospective database review of medical and p harmacy-related claims linked by episodes of care. Methods: Patients who had been diagnosed as having allergic rhinitis and ha d at least 1 prescription claim were identified from a database containing patient-level medical and pharmacy-related claims. The treatment patterns o f patients with allergic rhinitis who met the study criteria were documente d for a 12-month period in which the use of nonsedating antihistamines was described and the associated costs of various medications were assessed. Su banalyses of patients categorized by comorbidity status were also performed . Results: A total of 202,426 patients participated in the study. Nonsedating antihistamines were used by 71% of the patients; the most commonly prescri bed drugs were loratadine and fexofenadine. The mean annual charges per pat ient for the treatment of allergic rhinitis in the study population were $4 65.21 (standard deviation [SD], 548). The greatest departmental cost was th at oi pharmacy-related charges (mean, $236.02; SD, 233); the next highest c ost was that of outpatient charges (mean, $216.31; SD, 396). Comparisons of departmental charges indicated the use of loratadine was associated with s ignificantly higher treatment costs than that of fexofenadine in a number o f patient subgroups. Conclusion: In this analysis, loratadine was associated with significantly higher treatment charges than was fexofenadine. This result was observed co nsistently across different stratifications of patients, including the pres ence of comorbid respiratory infection, concomitant use of nasal steroids, and the presence of asthma and/or sinusitis. These results provided useful insights into the differential costs associated with the use of nonsedating antihistamines in the treatment of rhinitis.