Pharmacoeconomic research of antihistamine therapy used for persistent allergic rhinitis in children in Volgograd region

The article describes the pharmacoeconomic analysis results of the starting therapy with antihistamines (AGP-2 generation) used for allergic rhinitis (AR) in children. Aim: To conduct a comparative pharmacoeconomic analysis of the therapy efficacy with AGP-2 generation (cetirizine, rupatadine, bilastine) used for seasonal persistent AR in children. Materials and Methods: 95 patients aged 12 to 18 years with the diagnosis of seasonal persistent AR of moderate severity were divided into 3 treatment groups by stratification randomization method (sex, bronchial asthma (BA)): group 1 – cetirizine 10 mg with 1 tablet once a day (n = 31); group 2 – bilastine 20 mg by 1 tablet once a day (n = 32); group 3 – rupatadine 10 mg by 1 tablet once a day (n = 32). The study therapy lasted for 28 days. The treatment efficacy assessment included the effect of the disease on patients’ well-being by visual analogue scale (VAS); assessment of allergic rhinitis symptom severity by retrospective total nasal symptom severity rating scale (r-TNSS); number of days with well-controlled AR symptoms. Pharmacoeconomic analysis was performed using the cost-minimization analysis method and the cost-effectiveness method with calculation of the cost-effectiveness ratio (CER). Results: In the general patient population, pharmacoeconomic analysis using the “cost minimization” method was performed. It was established that the group of patients receiving cetirizine got advantages, and as a result such method of therapy allows to reduce treatment costs by 54.5 % and 3.5 % compared to the rupatadine and bilastine therapy options, respectively. Calculation of “cost-effectiveness” ratios in subgroups of patients with AR in combination with BA revealed that in the bilastine subgroup the CER ratio for the number of days with well-controlled AR symptoms was lower than in the other subgroups (by 58.9 % compared to the cetirizine subgroup and by 31.83 % less compared to the rupatadine subgroup. Conclusion: The cetirizine usage for patients with AR in the general population is pharmacoeconomically justified. The bilastine usage is economically advantageous for patients with multimorbid AR (AR+BA), during study the clinical advantages of rupatadine and bilastine usage have been revealed over cetirizine.