A cost minimization analysis of Azelastine/Fluticasone combination nasal spray versus azelastine and fluticasone nasal sprays monotherapy in moderate to severe allergic rhinitis: an experience from Islamic Republic of Iran

P. Zaboli, S. Nikfar, N. Ayati, E. Rohani, M, Toroski, D. Babaei

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Objectives
Allergic Rhinitis (AR) is a symptomatic disorder which is due to allergen exposure and IgE inflammatory pathway activation in respiratory tract. AR is categorized upon symptoms` type aand duration and its impact on patients` health related quality of life into mild and moderate to severe. AR treatment is based on allergen avoidance, medical therapy and immune therapy. Medical therapy includes oral and intranasal antihistamines and intranasal corticosteroids. Intranasal corticosteroids are first-line treatment in moderate to severe AR. This study aimed to assess Azelastine/Fluticasone combination nasal spray cost-effectiveness and budget impact in comparison with Azelastine and Fluticasone nasal sprays monotherapy in mild to moderate AR patients in Islamic Republic of Iran (I.R.I.) health care system.
Methods
A systematic review (SR) was performed to find relevent randomized clinical trials of Fluticasone/Azelastine (50μg/125μg), Fluticasone (50μg) and Azelastine (125μg) nasal sprays which evaluate their clinical effectivenesses. According to performed SR results, clinical effectiveness of two arms of study were approximately equal. Hence, a cost minimization analysis was done. As micro costing, direct medical costs (drugs` costs, GP office visits` costs, specialists` office visits` costs and allergy-related tests` costs), from official health tariffs book in I.R.I. were calculated from a payer perspective. Dollar currency rate was considered 32447.29 IRR/1$. Model time horizon was 14 day. Because of this short time horizon, discount rate was not applied. At last, a budget impact analysis was done according to AR incidence rate in I.R.I.
Results
Azelastine/Fluticasone combination nasal spray can save 2.05$ per patient for each course of treatment in AR patients in I.R.I. In addition, budget analysis results showed that it can minimize overall cost around 63755.5$ at the end of fifth year in AR patients I.R.I.
Conclusions
This study showed that Azelastine/Fluticasone combination nasal spray is a cost saving alternative in I.R.I. health care system.
Original languageEnglish
Pages (from-to)A647
Number of pages1
JournalValue in Health
Volume20
Issue number9
DOIs
Publication statusPublished - Oct 2017
Externally publishedYes

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