Cost burden of chronic rhinosinusitis: a claims-based study

Abstract

Objective: To quantify the cost burden and utilization of health care for chronic rhinosinusitis (CRS).

Study design: Historical cohort study.

Setting: Academic medical centers.

Methods: Medical claims data from 2003 to 2008 were analyzed. Patients were defined as having chronic sinus disease if they had a minimum of 2 CRS-related diagnoses with either computed tomography scanning or endoscopy performed between diagnoses. The prevalence and costs of CRS from the payer perspective (reimbursements) were determined.

Results: More than 4.4 million patients with an average of 3.1 years of eligibility and at least 1 diagnosis of acute rhinosinusitis (ARS) or CRS were studied. A total of 5.5% (95% confidence interval [CI], 5.4%-5.6%) of those with ARS were diagnosed with CRS in the subsequent 4 years. Among patients with chronic disease, after 12 months, 39% were still consuming care for CRS, and after 24 months, nearly 28% were still doing so. Of the CRS patients whose diagnosis was confirmed with endoscopy or radiology, 46.2% underwent endoscopic sinus surgery (ESS). In the year prior to ESS, patient care costs averaged $2449 ($2341-$2556). The ESS procedure plus 45-day postprocedure debridement and medical therapy costs averaged $7726 ($7554-$7898). In the year following the 45-day postprocedure period, consumption dropped by $885 (P < .0001). In the second year following ESS, therapy costs dropped an additional $446 (P < .0001).

Conclusions: A significant proportion of CRS patients require ongoing treatment of their sinus disease for years. Sinus surgery appears to reduce consumption of rhinosinusitis-related health care, but costs related to the procedure are significant.