Assessment of intranasal corticosteroid use in allergic rhinitis: benefits, costs, and patient preferences.

Current medical guidelines for allergic rhinitis, a highly prevalent disorder, recommend an intranasal corticosteroid as a safe and effective pharmacotherapeutic option. The 6 intranasal corticosteroids available in the United States have approximately equivalent efficacy, although their formulations differ and patients express preferences for specific products. While they are all generally safe at recommended doses, patient preference may increase willingness to adhere to a treatment regimen, a major goal when long-term therapy is required. Another important factor involves the direct costs of treatment associated with each intranasal corticosteroid. This review presents comparative economic data from a retrospective study using a large managed care database as well as data from controlled clinical studies comparing patient preferences for specific attributes of 4 intranasal corticosteroids. When possible, comparative data from clinical trials that assess patient preference, potential treatment adherence, and costs, as well as their interrelationships, should be considered when evaluating intranasal corticosteroid use in the managed care setting.