Treating the Ocular Component of Allergic Rhinoconjunctivitis and Related Eye Disorders

Leonard Bielory, MD; C. H. Katelaris, MD; Susan Lightman, FRCP, FRCOphth, PhD; Robert M. Naclerio, MD

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Economic Burden

The healthcare costs related to AR, including those for rhinoconjunctivitis, have been reported to be $5.9 billion in the United States, with medication use accounting for 25% of the costs (approximately $1.6 billion).[5] Of the $1.58 billion spent on prescription medication for AR in 1996, second-generation antihistamines accounted for 51%, intranasal corticosteroids (INS) 25%, and first-generation antihistamines 5%.[26] Prescription medication costs attributable to ocular allergy have increased substantially in the past decade to more than $200 million, and these costs are predicted to increase by approximately 25% per year.[5] Current expenditure in the United States is therefore likely to be approximately $500 million. The total number of prescriptions for ocular allergy in the United States has increased in parallel with these costs by a rate of 20% per year. In 2000, 30% of these prescriptions were written by primary care providers, while a further 50% could be attributed to eye care and allergy specialists (41% and 9%, respectively).[5]

In Europe, a study based in the United Kingdom estimated that the healthcare costs for an employed person with SAC totaled £124 per year, of which £46 could be attributed to medication.[19] Interestingly, SAC sufferers were significantly more likely to be unemployed than controls.[19] A Spanish study found the direct cost of SAC to be 151 Euros per patient, with medication costs totaling 68 Euros.[20] The associated costs of reduced productivity were higher, equating to 198 Euros.[20] In combination, these studies suggest that ocular allergy may cause a significant economic burden.

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