LETTER
Cost and the Common Cold
Lee C. Vermeulen Jr., MS
15 January 1997 | Volume 126 Issue 2 | Pages 173-174
TO THE EDITOR:
Hayden and colleagues [1] assessed the efficacy of intranasal ipratropium in the management of the common cold but failed to consider the cost of this treatment.
The product (Atrovent nasal spray, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut) is available at an average wholesale price of $24.00 [2]. When the pharmacy dispensing fee is added, the cost of therapy exceeds $30.00. In formulating coverage decisions, managed care organizations not only consider the cost of the medication but also review other potential costs and savings associated with the treatment. If ipratropium could show clinical benefits that, for example, reduced the number of work days lost, its price might be justified. Ipratropium, however, does not alleviate the constitutional symptoms associated with the common cold (such as malaise, aches, and pains) that result in decreased productivity.
Regardless of the safety and efficacy of this product, its inherent lack of cost-effectiveness and inordinately high cost is indefensible for the management of a self-limiting disease associated with almost no morbidity.
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Author and Article Information
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University of Wisconsin Hospitals and Clinics, Madison, WI 53792
1. Hayden FG, Diamond L, Wood PB, Korts DC, Wecker MT. Effectiveness and safety of intranasal ipratropium bromide in common colds. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1996; 125:89-97.
2. Drug Topics Red Book. Montvale, NJ: Medical Economics; 1996.
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