Chronic Rhinosinusitis: 5% of the annual U.S. health care budget

Published Online: October 16, 2015

Chronic rhinosinusitis (CRS) is a complex inflammatory disease affecting the nose and sinuses of an estimated 5% of Canadians and 2-16% of the United States population. Those affected by CRS experience a significant decrease in quality of life and productivity. CRS often results in long-term impairment and, for some, disability. With the current international climate of health policy reform, it is critical to understand the economic burden of diseases. Given the prevalence of CRS and its various impacts, it is important that the cost of treatment for this disease be well understood by policy makers and payees.

In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Caulley and colleagues used the US Medical Expenditure Panel Survey (MEPS) to evaluate the direct costs of CRS care from the perspective of the United States government. The authors used 4 accepted methods of direct cost estimation so that differences in the totals from these methods could be appreciated and to avoid the potential bias of a single estimation method. Further, the authors utilized the CRS disease prevalence of the MEPS population when presenting direct costs to mitigate the bias of choosing an arbitrary prevalence estimate.

The researchers found that the estimated prevalence of CRS in the most up to date MEPS survey panel (2011) was 3.5%.  Depending on the employed cost estimation method, the direct cost of CRS treatment per individual ranged from $5,560 to $5,955 USD per year. For 2011, this resulted in an expenditure of  $60.2 to 64.5 billion USD for the treatment of patients with CRS. This total expense accounted for 4.5 to 4.8% of the overall expenditures for US health care. Further, the upper limit of the incremental national expenditure due to CRS was estimated at 12.5 billion USD. This constituted 0.94% of the total US health care budget for 2011. Compare this to the most recent annual estimate (2007) of 8.6 billion USD.

The authors showed that this complex chronic inflammatory disease has an economic burden that continues to rise substantially, and the burden of CRS on annual health care budgets has been previously underestimated. These study results aid CRS advocates, policy makers, and other stakeholders alike to understand the direct costs of CRS treatment.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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