Cost-effectiveness of mometasone furoate nasal spray in the treatment of acute rhinosinusitis.

Acute rhinosinusitis is a common disease with an increasing incidence rate. It causes substantial costs to the individual and to society through healthcare consumption and absence from work. The use of antibiotics is widespread in the treatment of acute rhinosinusitis, but increasing bacterial resistance is an argument for restricting excessive use of antibiotics. The aim of this study was to analyse the cost-effectiveness of mometasone furoate nasal spray (MFNS) compared with amoxicillin or non-active treatment of mild to moderate acute rhinosinusitis in a Swedish setting. A cost-effectiveness model was developed to capture the costs and health-related quality of life (HRQoL) over a 15-day period. Acute rhinosinusitis was modelled as changes in the Major Symptom Score. The model takes on a societal perspective in a Swedish setting. Efficacy data were taken from a randomised clinical study. The model has three treatment arms: (A) MFNS 200 μg twice daily, (B) amoxicillin 500 mg three times daily, and (C) placebo. Information about resource utilisation and HRQoL was taken from a recent observational study. Costs were reduced and quality-adjusted life years were increased with MFNS 200 μg twice daily compared with amoxicillin 500 mg three times daily. MFNS was cost-saving or cost-effective compared with amoxicillin or non-active treatment in the sensitivity analyses regardless of the HRQoL measurement used. This study shows that treatment with MFNS 200 μg twice daily results in lower costs and improved HRQoL in acute rhinosinusitis compared with amoxicillin or self-medication.