Direct Costs of Acute Rhinosinusitis in Spain: A Prospective and Observational Study (PROSINUS)

Abstract

Background: The incidence of acute rhinosinusitis (ARS) is high throughout the world. Although diagnosis is clinical and disease course is mostly self-limiting, diagnostic tools and medications are overused by physicians, thus increasing the direct medical costs of the disease. Objective: The aim of the PROSINUS study was to quantify the direct medical costs of management of ARS in Spain. Methods: We performed a prospective observational study of 1610 patients with a clinical diagnosis of nonbacterial, uncomplicated ARS. According to the duration of symptoms by the European Position Paper on Rhinosinusitis and Nasal Polyps, patients were classified as having viral or postviral ARS with different levels of severity. Direct medical costs were calculated based on medical visits, use of diagnostic tools, and medications prescribed. Results: Overall, the mean (SD) direct medical costs per episode were €322.3 (301.2) vs €441.1 (344.3) for viral and postviral ARS episodes, respectively (P<.001). When viral and postviral disease were compared, the medical costs per episode were €245.0 (265.4) vs €328.4 (301.9) for medical visits (P<.001), €38.1 (64.0) vs €61.9 (78.8) for diagnostic tools (P<.001), and €39.2 (25.9) vs €50.8 (25.3) for medications prescribed (P<.001). Conclusions: The direct medical costs of postviral ARS episodes were higher than those of viral episodes (common cold). Uncomplicated nonbacterial ARS represents an important socioeconomic burden owing to the excessive number of medical visits, use of diagnostic tools, and medications prescribed. Key words: Acute rhinosinusitis. Common cold. EPOS. Direct costs. PROSINUS.