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Incremental healthcare utilization and expenditures for allergic rhinitis in the United States


  • Neil Bhattacharyya MD, FACS

    Corresponding author
    1. Division of Otolaryngology, Brigham and Women's Hospital, Boston, Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
    • Division of Otolaryngology, Harvard Medical School, 45 Francis Street, Boston, MA 02115
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  • N.B. is a consultant for Intersect-ENT, Inc. and Entellus, Inc.

  • The author has no conflicts of interest to declare.



Determine incremental increases in healthcare expenditures and utilization associated with allergic rhinitis (AR).


Patients reporting a diagnosis of AR were extracted from the 2007 Medical Expenditure Panel Survey medical conditions file and linked to the consolidated expenditures file. AR patients were then compared to non-AR patients determining differences in healthcare utilization: office visits, emergency facility visits, and prescriptions filled, as well as differences in healthcare expenditures: total healthcare costs, office-based costs, prescription medication costs, and self-expenditures using demographically and comorbidity adjusted multivariate models.


An estimated 17.8 ± 0.72 million adult patients reported AR in 2007 (7.9 ± 0.3% of the U.S. population). The additional incremental healthcare utilizations associated with AR relative to non-AR patients for office visits, emergency facility visits, and number of prescriptions filled were 3.25 ± 0.40, 0.01 ± 0.02, and 8.95 ± 0.80, respectively (P < .001, .787, and <.001, respectively). Similarly, additional healthcare expenditures associated with AR for total healthcare expenses, office-based visit expenditures, prescription expenditures, and self-expenditures were $1,492 ± 346, $461 ± 122, $876 ± 126, and $168 ± 25, respectively (all P < 0.001).


AR is associated with substantial incremental increases in healthcare utilization and expenditures due to increases in office-based visits and prescription expenditures. As a commonly prevalent and costly disease, AR would be a prime target for guideline development and standardization of care. Laryngoscope, 2011