Pharmacoeconomics of Cyclamen europaeum in the management of acute rhinosinusitis

Objectives/hypothesis: To carry out a pharmacoeconomic analysis of Cyclamen europaeum (CE) in the management of acute rhinosinusitis (ARS) in Spain using data from the PROSINUS (PROspective epidemiological study of the diagnosis and treatment of acute rhinoSINUSitis) study.

Study design: This was a prospective observational study to compare the effectiveness and cost-effectiveness between therapies including CE versus other therapies in the management of ARS.

Methods: The study was carried out as a secondary analysis of the PROSINUS study, combining healthcare resource use, productivity loses, and health outcomes from the observational study, with costs representative of the Spanish Health System.

Results: CE given as monotherapy appears to be more effective (cure rate) than other monotherapies (15.3% higher, P < .05) and combination (10.3% higher, P < .05) therapies. The addition of CE to other single-drug or combination therapies showed a statistically significant improvement in terms of cure rates when adding CE to two-drug combinations (93.9% vs. 76.5%; P < .05) and no significant effect when added to combinations of three or more drugs (81.1% vs. 79.8; nonsignificant). CE-based therapies generally showed lower indirect costs, although only the comparison of CE alone versus other monotherapies, with a net cost savings of €101 per patient, reached statistical significance (€331 vs. €432, P < .05). In addition, CE-based therapies show lower cost per cured patient in all comparisons, except when CE was used in combination with three or more other drugs.

Conclusions: The use of CE (Nasodren) may be associated to better clinical outcomes at no additional cost for the healthcare system with respect to treatments commonly used for ARS in clinical practice.