Consumption and Treatment Costs of Therapy with Corticosteroid-Containing Nose sprays

AIM: The most frequently prescribed nose sprays with corticosteroids contain the active substance budesonide (BHN) or mometasone (MHN) in Germany. Despite pharmacological differences between the two active substances a unique defined daily dose (DDD) is assumed. Our analysis of prescription data was to determine the prescribed daily doses of the two substances in real-life practice and to compare treatment cost. METHODS: Analysis of longitudinal diagnosis and prescription data of the IMS® Disease Analyzer database from October 2004 to September 2006. RESULTS: Data were available for 14 767 MHN and 2489 BHN patients of general practitioners (GPs) and an additional 8,817 MHN and 748 BHN patients of ear-nose-throat specialists (ENTs). Need for follow-up prescription, change to another nose spray, and application of the maximum dose occurred less frequent for MHN compared to BHN treatment. The overall drug consumption was lower for MHN and differed on average from BHN by -105.4 (at time of initial prescription) and -260.1 puffs (after 730 days) prescribed by GPs and by -90.9 to -435.0 puffs prescribed by the ENTs (p < 0.0001). The mean treatment cost per year were 16.38 EUR and 24.70 EUR for MHN at the GPs and ENTs sites compared to 16.94 and 34.04 EUR for BHN from the perspective of the German statutory health insurance system. CONCLUSION: The prescribed doses of MHN are lower than that of BHN in everyday practice. No cost benefit is detectable for treatment with BHN compared to MHN from the perspective of the German statutory health insurance system based on the real consumption individually observed for the two drugs.