COST-EFFECTIVENESS AND QUALITY-OF-LIFE OUTCOMES OF MONTELUKAST–LEVOCETIRIZINE VERSUS MONTELUKAST–BILASTINE IN ALLERGIC RHINITIS: A PROSPECTIVE OBSERVATIONAL STUDY
Main Article Content
Keywords
Allergic rhinitis, montelukast, levocetirizine, bilastine, cost-effectiveness, quality of life.
Abstract
Background: Allergic rhinitis (AR) substantially impairs quality of life and imposes direct and indirect economic burdens, particularly in countries with high out-of-pocket health expenditure. Fixed-dose combinations of montelukast with second-generation antihistamines are widely prescribed, yet comparative data on cost-effectiveness and patient well-being in the Indian setting are limited.
Methods: Current prospective observational study was conducted in a tertiary care centre and included 60 patients with AR, with or without coexisting asthma. Group A(n=30) participants received montelukast 10 mg + levocetirizine 5 mg whereas Group B(n=30) participents recieved montelukast 10 mg + bilastine 20 mg once daily. Quality of life was assessed using the WHO-5 Well-Being Index at baseline and day 28. Direct drug costs were estimated from market prices of ten widely available brands per group. Cost-effectiveness ratio (CER) was calculated as cost per unit reduction in Total Nasal Symptom Score (TNSS).
Results: Findings revealed that baseline characteristics were comparable between groups. Both regimens significantly improved WHO-5 well-being scores (mean improvement: 9.43 ± 3.24 in Group A vs 9.24 ± 2.57 in Group B; and reduced TNSS (6.64 ± 1.60 vs 6.54 ± 1.38; p=0.81). The average 28-day cost was lower in Group A (₹403.84 ± 212.90) than Group B (₹457.99 ± 139.56). CER was numerically lower for montelukast–levocetirizine (₹60.82 ± 32.06) compared to montelukast–bilastine (₹70.03 ± 21.34), not statistically significant (p=0.511).
Conclusions: Both combinations effectively improved well-being and symptom control. Montelukast–levocetirizine offered a modest economic advantage, whereas montelukast–bilastine provided a non-sedating alternative. These findings support patient-centred, value-conscious prescribing decisions in AR managemt.
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Debendra Suman
Department of Pharmacology & Therapeutics, King George’s Medical University, Lucknow, Uttar Pradesh, India
Ajay Kumar Verma
Department of Respiratory Medicine, King George’s Medical University, Lucknow,Uttar Pradesh, India
Jyoti Bajpai
Department of Respiratory Medicine, King George’s Medical University, Lucknow,Uttar Pradesh, India
Rajendra Nath
Department of Pharmacology & Therapeutics, King George’s Medical University, Lucknow, Uttar Pradesh, India
Narendra Kumar
Department of Pharmacology & Therapeutics, King George’s Medical University, Lucknow, Uttar Pradesh, India
Suyog Sindhu
Department of Pharmacology & Therapeutics, King George’s Medical University, Lucknow, Uttar Pradesh, India
Rakesh Kumar Dixit
Department of Pharmacology & Therapeutics, King George’s Medical University, Lucknow, Uttar Pradesh, India