Epidemiology and Burden of Recurrent Acute Rhinosinusitis

Objective: 1) Learn about the epidemiology of recurrent acute rhinosinusitis (RARS). 2) Understand healthcare costs attributable to RARS as a potentially underdiagnosed form of chronic rhinosinusitis. Method: Medical claims data (2003-2008) from a large payer database were analyzed. Adult patients with RARS (defined as at least 4 acute rhinosinusitis [ARS] claims each with a filled oral antibiotic prescription in a 12-month period) were extracted. Diagnostic procedures, surgery rates, and medical costs were determined. Results: A total of 4,588 patients were identified (mean age, 43.5 years; 72.1% female) among 13.1 million patients, for a point prevalence of 0.035%, which remained consistent across years. After 1, 2, and 4 years, 2.4%, 5.4%, and 9.2% of patients subsequently received nasal endoscopy and 11.4%, 23.5%, and 39.9% received paranasal sinus computed tomography, respectively. Similarly, 0.2%, 2.0%, and 4.1% underwent endoscopic sinus surgery at these same intervals. Average total healthcare costs related to RARS averaged $1207/patient-year. Antibiotic and nasal prescription costs averaged $210 and $452, and an average of 3.8 antibiotics were filled per patient-year with RARS. Conclusion: RARS may affect approximately 1 in 3000 adults. Despite significant health care costs over $1000/year per individual patient with RARS, nasal endoscopy and computed tomography are not commonly obtained early after potential diagnosis. RARS is likely an underdiagnosed condition warranting further study.