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Oral antihistamines are generally the most affordable allergic rhinitis treatments, while fixed antihistamine–INCS combinations tend to be the most expensive, with costs varying substantially worldwide.
Allergic rhinitis (AR) medications can vary substantially in both availability and affordability between countries and across different periods. A global survey conducted among experts from the Allergic Rhinitis and its Impact on Asthma (ARIA) group has now mapped these differences across multiple medication classes and geographic regions.
Researchers conducted a survey of ARIA experts from 51 countries to assess the availability and lowest reported prices of commonly used AR medications in each country. Prices provided in local currencies were converted into 2024 US dollars using Purchasing Power Parity (USD PPP), enabling meaningful cross-country comparisons. The analysis compared the costs of different medication classes by selecting the least expensive available drug within each class in each country and assuming full adherence to intervention.
Availability differs between medication classes
Two major treatment classes—intranasal corticosteroids (INCS) and oral antihistamines (OAH)—were reported to be available in all 51 countries. In contrast, availability was not universal for intranasal antihistamines (INAH) or fixed-dose INAH + INCS combinations, indicating potential differences in access to these treatment options across countries.
OAHs generally offer the lowest cost
A clear difference emerged when medication classes were compared by cost. In most countries, OAHs were the least expensive medication class, whereas INAH + INCS combinations were generally the most expensive. Among INCS, beclomethasone was the medication most commonly detected by experts as the lowest-cost option.
For OAH, cetirizine and loratadine were the medications most commonly reported as the least expensive choices. The cost comparison also identified differences between fixed antihistamine–corticosteroid combinations. Among INAH + INCS products, azelastine–fluticasone was more commonly identified as the less costly option vs. olopatadine–mometasone.
Asia reports the lowest costs, South America the highest
The geographic analysis revealed substantial regional variation in medication costs. Asia illustrated the lowest overall medication costs, while South America illustrated the highest reported costs. Thus, the affordability of AR treatment depends not only on the medication class selected but also on the country and region in which the treatment is obtained.
The investigators noted that these findings will contribute to the ARIA–European Academy of Allergy and Clinical Immunology (EAACI) 2024–2025 guidelines, helping inform recommendations that take treatment availability and affordability into consideration.
Allergy
Availability and Costs of Allergic Rhinitis Treatments Across the World: A Survey of ARIA Experts
Maria Clara Urbano et al.
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