Availability and Costs of Allergic Rhinitis Treatments Across the World: A Survey of ARIA Experts

INTRODUCTION: Medication availability and costs can be highly variable across countries and in different time periods. We aimed to conduct a survey among local experts to obtain information on the availability and costs of allergic rhinitis medications in different countries. METHODS: We sent a survey to members of the Allergic Rhinitis and its Impact on Asthma (ARIA) group, asking for the availability and the lowest cost of specific allergic rhinitis medications in their respective countries. Data in local currencies were converted to 2024 US Dollars adjusted for Purchasing Power Parity (PPP). We compared the costs of different medication classes, assuming, for each class, the least expensive drug in each country, as well as full treatment adherence. RESULTS: We received responses from ARIA experts in 51 different countries. Intranasal corticosteroids (INCS) and oral antihistamines (OAH) were available in all countries, but this was not observed for intranasal antihistamines (INAH) or for INAH+INCS. In most countries, OAH was the least costly drug class, while INAH+INCS was the most expensive. Among INCS, beclomethasone was the medication most frequently identified as the cheapest, while cetirizine and loratadine were the OAH most frequently reported as the least expensive. Among INAH+INCS, azelastine-fluticasone was more frequently identified as less costly than olopatadine-mometasone. CONCLUSION: There is an important across-country and across-class variability in terms of costs of allergic rhinitis medications. The results of this study will inform the ARIA-EAACI 2024-2025 guidelines.