A Budget Impact Analysis of Azelastine Hydrochloride/Fluticasone Propionate (AzeFlu) Nasal Spray Suspension for Patients With Allergic Rhinitis (AR) in the Kingdom of Saudi Arabia

OBJECTIVES: This analysis assesses the potential budget impact of introducing azelastine hydrochloride/fluticasone propionate (AzeFlu) nasal spray suspension in government hospitals across Saudi Arabia for individuals with Allergic Rhinitis (AR).

METHODS: An Excel-based model was designed to assess national budget impact over a span of five years. Demographic data, including prevalence rates of AR and access to health care services, were gathered from peer reviewed secondary sources and local experts. The study focused on medicine costs, using publicly available prices from the Saudi FDA website. Two key scenarios were assessed: S1) AzeFlu prescribing partially replacing dual free combination treatment regimens and S2) AzeFlu partially replacing triple free combination regimens (as S1, adding eye drops).

RESULTS: For S1, over the course of 5 years, introducing and gradually increasing AzeFlu prescribing, while reducing the share of dual free combination therapies, could lead to a saving of 1.4 million SAR, roughly 0.4% of the total baseline budget. In addition, for S2, replacing triple free combination therapies with AzeFlu could result in an estimated saving of 9.9 million SAR, equivalent to approximately 1.8% of the total baseline budget. Sensitivity analysis of assumed future prescription prescribing impacts the relative results, while bootstrapping of AR prevalence uncertainty demonstrates limited absolute impact on the results.

CONCLUSIONS: Introducing AzeFlu, which has shown significant higher AR symptom relief vs its mono-components, into Saudi government hospitals would not only be cost saving compared to existing dual and triple combination products but could also result in even greater cost savings with fewer health care provider visits. Furthermore, for patients suffering from asthma the cost savings could also be greater. The reduction in the overall medicines burden associated with dual and triple free combination treatment regimens, makes the introduction of AzeFlu an alternative treatment option for patients in government hospitals across Saudi Arabia.