Allergies in America: A Landmark Survey of Nasal Allergy Sufferers

Executive Summary

Conducted bySchulman, Ronca & Bucuvalas, Inc.

February 17, 2006

Supported by:

2

Study Design

Population Sampling Frame Interview Length

Completed Sample

Population Aged 18+ National RDD 34.8 minutes 2,500

Cross-section: 1/4/06-1/31/06

Health Professionals Doctors

-- Adult Primary Care

-- Allergy

-- Otolaryngology

Nurse practitioners

Physician assistants

AMA/AOA Master List:

Licensing Boards

American Academy of Physician Assistants

19.4 minutes

100

100

100

50

50

Physician Survey: 1/17/06-2/14/06

3

Adults Diagnosed with Nasal Allergies: Household Screening

QA. Including yourself, how many persons, aged 18 and older, live in this household (even if they are not there right now)? QB. Have any of these persons been diagnosed as having hay fever, rhinitis, or nasal

allergies? QC. How many persons, 18 or older, in this household have been diagnosed with hay fever, rhinitis or nasal allergies? N=61,655 adults in 31,470 households

Not diagnosed, 86%

Diagnosed, 14%

4

Seasonal or Persistent Allergies

Not sure1%

Seasonal43%

Throughout the year56%

Q12. Would you describe your nasal allergies as seasonal or do they occur throughout the year? N=2,500

5

Symptoms During Worst Month

29%

25%

40%

12%

23%

13%

6%

11%

28%

30%

17%

15%

20%

10%

12%

12%

6%

10%

17%

16%

0% 20% 40% 60% 80% 100%

Repeated Sneezing

Watering Eyes

Stuffed up nose

Awakened / Unable to Sleep

Itching

Headache

Ear Pain

Facial Pain

Runny Nose

Post-nasal drip

Every day

Most days

Q14. During the worst one month period in the past year, did you have (symptom) every day, most days a week, a few days a week, a few days a month, less than that, or never? Unweighted N=2,500

6

How Bothersome are Symptoms

11%

16%

28%

26%

19%

33%

20%

28%

26%

25%

18%

40%

23%

20%

38%

36%

27%

31%

30%

31%

0% 20% 40% 60% 80% 100%

Repeated Sneezing

Watering Eyes

Red, itching eyes

Stuffed up nose

Itching

Headache

Ear Pain

Facial Pain

Runny Nose

Post-nasal drip

Extremely

Moderately

Q15. When you have nasal allergy attacks, how bothersome are the following symptoms usually --- extremely bothersome, moderately bothersome, slightly bothersome, or not bothersome? N=2,500

7

Most Bothersome Symptom

22%

14%

14%

10%

10%

9%

7%

5%

4%

4%

0% 5% 10% 15% 20% 25%

Stuffed up nose

Headache

Post-nasal drip

Red, itching eyes

Runny Nose

Repeated Sneezing

Facial Pain

Watering Eyes

Ear Pain

Itching

Most bothersome

Q16. Which of these symptoms was the most bothersome to you? Base: Had bothersome symptoms N=2,362

8

Degree of Discomfort from Allergies

Not sure1%

Can't Tolerate38%

Can Ignore6%

Can Tolerate55%

Q17. In general, when you have a nasal allergy attack would you say that your discomfort is usually something you can ignore, you can’t ignore it, but you can tolerate it, or you can’t tolerate it without relief? N=2,500

9

Symptoms During Worst Month

13%

26%

44%

8%

29%

23%

38%

36%

15%

36%

0%

20%

40%

60%

80%

100%

Depressed orblue

Irritable Tired Embarrassed Miserable

Sometimes

Frequently

Q30. During allergy season, how often do you feel (ITEM) – frequently, sometimes, rarely or never? N=2,500

10

Impact of Allergies on Daily Life

Not sure1%

Didn't really impact14%

Little19%

Some26%

A lot15%

Moderate25%

Q31. During allergy season, would you say the condition impacted your daily life …..? N=2,500

11

Work Interference from Nasal Allergies

Neither48%

Both20%

Missed work only10%

Interfered only22%

Q22a. Have you missed work in the past 12 months due to your nasal allergies? Q23a. Aside from actually missing work, have your nasal allergy symptoms in the past 12 months interfered with your performance at work? Base: Employed full time N=1,315

12

Productivity and Allergies

95%

72%

0%

20%

40%

60%

80%

100%

No Symptoms Symptoms at worst

Q24. Thinking about your productivity on a scale of 0 to 100, where 100 means 100% productivity, where would your rank your productivity on days when you don’t have nasal allergy symptoms? Q25. Where would you

rank your productivity on the same scale of 0 to 100 … when your nasal allergies are at their worst? Base: Employed full time N=1,315

Mean Productivity

13

Seen Doctor for Nasal Allergies in Past 12 Months by Symptom Severity

Q42a. Have you seen a health practitioner about your nasal allergies in the past 12 months? Q33. How would you describe your nasal allergy symptoms during the last week? Would you say that you had no symptoms, mild symptoms, moderate symptoms or severe symptoms? N =2,500

47%

32%

47%

55% 57%

0%

20%

40%

60%

80%

100%

All patients No symptoms Mild Symptoms Moderatesymptoms

Severesymptoms

14

Medicine for Allergies in Past 4 Weeks

Q63a. In the past 4 weeks, have you used any over-the-counter, non-prescription medicine to give you relief from nasal allergy symptoms? Q63b. When was the most recent time that you used an over the counter, non-prescription medicine for relief from nasal allergy symptoms? Q64a. In the past 4 weeks, have you used any prescription nasal spray for your nasal allergies? Q64b. When was the most recent time that you used a prescription nasal spray for your nasal allergies? Q72a. Have you taken any other prescription medications

for your nasal allergies in the past 4 weeks? N=2,500

53%

36%

22%

45%

69%

31%

0%

20%

40%

60%

80%

100%

OTC Rx NasalSpray

Other Rx Any Rx AnyMedication

No Medication

15

Satisfaction with Recent Rx Nasal Spray for Nasal Allergies

Q63f. How satisfied are you with the over-the-counter medicine you used for your nasal allergies in the past 4 weeks? Q70a. How satisfied are you with the prescription nasal spray you used for your nasal allergies in the past 4 weeks? Q78. How satisfied are you with the other prescription medicine you used for your nasal allergies in the past 4 weeks?

48%39%

38%

52%49%41%

0%

20%

40%

60%

80%

100%

Recent OTC N=1,344 Recent Rx Spray N=919 Other Recent Rx N=576

Very satisfied Somewhat satisfied

16

How Many Symptoms Relieved by Nasal Spray

Q65. Does your current prescription nasal spray give you relief from all of your symptoms, most symptoms, some symptoms, or no symptoms? Base: Use prescription nasal spray. N=919

Not sure, 1%

None, 3%

Some, 34%

Most, 46%

All, 16%

17

How Quickly Does it Relieve

Q68. How long does it take for your current prescription nasal spray to begin giving you symptom relief? Base: Use prescription nasal spray N=919

37%

21%

8%

2% 1% 1%2%

12%

4%

0%

10%

20%

30%

40%

50%

Within 1hour

1 hour 2 hours 3-4hours

5-6hours

7-10hours

11-23hours

1-6 days Oneweek or

more

18

Does Effectiveness Wear Off

Q69a. Does your current prescription nasal spray lose effectiveness over the course of the day or night, or does it remain as effective as when you first took it? Base: Use prescription nasal spray N=919

Not sure, 7%

Does not, 45%

Loses effectiveness, 48%

19

When Begins Losing Effectiveness

Q69b. How long after taking your current nasal allergy medicine does it begin losing effectiveness? Base: Nasal spray loses effectiveness N=440

18%

32%

20%

17%

3%

5%

5%

0% 10% 20% 30% 40% 50%

Less than 4 hours

4-7 hours

8-11 hours

12-15 hours

16-23 hours

24 hours or longer

Not sure

20

Change Prescription Medicines for Nasal Allergies

Q81a. How often do you change nasal allergy medicines ---several times each year, once a year, every few years, only rarely or never? N=2,500

Several times a year, 10%

Not sure, 2%

Once a year, 8%

Every few years, 12%

Only rarely, 38%

Never, 29%

21

Why Changed Medicine for Nasal Allergies

Q81b. Why have you changed nasal allergy medicines? Anything else? Base: Have changed nasal allergy medicines N=1,723

37%

23%

11%

8%

5%

4%

3%

3%

3%

3%

2%

2%

2%

1%

3%

4%

0% 10% 20% 30% 40% 50%

Not effective enough

Doctor wanted to try other

Patient wanted to try other

Bothersome side effects

Cost/co-pay

Didn't treat symptoms

Not covered

Safety concerns

Developed an immunity

Availability/ Convenience/ Free samples

Not long lasting enough

Taken off market

Haven't changed allergy medicines

Not fast enough

Not sure

Other

22

Asked Doctor to Change Medication

Q82a. Have you ever asked your doctor to change your nasal allergy medication because you were dissatisfied with it? N=2,500

No, 66%

Yes, 34%

23

Why Dissatisfied with Nasal Allergy Medicine

Q82c. Why were you dissatisfied with that medicine? Base: Have asked doctor to change nasal allergy medicines N=860

66%

21%

12%

10%

1%

1%

1%

4%

2%

0% 20% 40% 60% 80% 100%

Wasn't effective

Bothersome side effects

Effectiveness wore off

Didn't provide 24 hour relief

Not covered

Cost/co-pay

Hard to administer

Other

Not sure

24

Effectiveness Ever Wore Off before 24 Hours

Q87a. Have you ever found that the effectiveness of a product that promised 24 hour relief began wearing off earlier? N=2,500

Not sure, 9%

No, 33%

Yes, 58%

25

When Does Effectiveness Wear Off

Q87c. About how long after you started taking it does a nasal allergy medicine’s effectiveness begin wearing off? Base: Found nasal allergy medicine offering 24 hour relief wearing off N=1,461

3%2%

3%

15% 15%

19% 19%

25%

0%

10%

20%

30%

40%

50%

Within 1hour

1 hour 2 hours 3-4 hours 5-6 hours 7-10hours

11 ormore

Not sure

26

Stopped Taking Because Effectiveness Wore Off

Q87d. Have you ever stopped taking a product for your nasal allergies because its effectiveness had worn off?

33%

57%

0%

20%

40%

60%

80%

100%

All Patients N=2,500 Experienced Wear-off N=1,461

27

Effectiveness Wears Off Over Time

Q88a. Have you ever found that a product’s effectiveness in treating your nasal allergy symptoms wears off over time even when you are taking the medicine as prescribed? Q88b. Has this happened to you with more

than one nasal allergy product? N=2,500

Not sure, 6%

No, 40%

Yes, not sure how many, 2%

Yes, one, 15%

Yes, more than one, 38%

28

When Does Effectiveness Wear Off

Q88c. About how long after you started taking it does a nasal allergy medicine’s effectiveness begin wearing off even when taken as prescribed? Base: Found nasal allergy medicine wearing off N=1,364

12%

7% 6%

13% 13%

10%12%

27%

0%

10%

20%

30%

40%

50%

Within 1month

1 month 2 months 3-4months

5-6months

7-10months

11 ormore

months

Not sure

29

Stopped Taking Because Effectiveness Wore Off

Q88d. Have you ever stopped taking a product for your nasal allergies because its effectiveness had worn off?

36%

66%

0%

20%

40%

60%

80%

100%

All Patients N=2,500 Experienced Wear-off N=1,364

30

Side Effects of Allergy Medicines

8%

3%

11% 10%

2% 4%

7%

3%

8%12%

7%

17%

11%

22%

25%

12%

26%

2%

0%

10%

20%

30%

40%

50%

Bad taste Burning Drippingdown throat

Dryingfeeling

Headaches Drowsiness

Some

Most

All

Q90. How many of the medicines that you have taken for allergy had the following types of side effects --- all, most, some, few or none? N=2,500

31

How Bothersome are Side Effects

7% 7%

13% 12% 12% 12%

15%11%

20% 22%

13%

21%

0%

10%

20%

30%

40%

50%

Bad taste Burning Drippingdown throat

Dryingfeeling

Headaches Drowsiness

Moderately

Extremely

Q91. How bothersome are the following side effects of nasal allergy medicines --- extremely, moderately, slightly or not bothersome? N=2,500

32

Reason Stopped Taking Nasal Allergy Prescription

Q94. Have you ever stopped taking a nasal allergy medicine prescribed by your doctor because…. N=2,500

37%

35%

32%

25%

14%

11%

4%

3%

39%

0% 10% 20% 30% 40% 50%

Didn't find it effective

Effectiveness began wearing off

Didn't provide 24 hour relief

Bothersome side effects

Not covered

Co-pay was too high

Dosing schedule was difficult

Hard to administer

None of these

33

How often Patients Follow Advice

Q19. Would you say that most of your patients with allergic rhinitis follow your advice on the management and treatment of nasal allergies…? N=400

PQ49. Would you say that you follow your health practitioner’s advice on the management and treatment of your nasal allergies – all of the time, most of the time, some of the time, rarely or never? N=2,500

41%

32%

1%

1%

1% 67%

70%

57%

39%

38%

45%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary care

Nurse Prac./PhysicianAsst.

Patients who have seendoctor

Patients who have notseen doctor

All of the time

Most of the time

34

Failed to Follow Physician Instructions

Q108. People with nasal allergies sometimes fail to follow their physician’s instructions about their medicines for allergies. Have you ever failed to take an allergy medicine as prescribed because of ……

N=2,500

41%

37%

35%

27%

22%

21%

19%

19%

3%

0% 10% 20% 30% 40% 50%

Lack of symptom relief

Loss of effectiveness over time

Lack of symptoms

Troublesome side effects

Worry about side effects

Cost of drugs

Concern about long term use

Poor toleration

Doctor's instructions hard to follow

35

Important for Nasal Allergy Medicine

Q98. In choosing a nasal allergy medicine, which would be the most important to you …? Q99. What would be the next most important to you? N=2,500

17%

32%

37%

6%

5%

22%

30%

15%

13%

13%

2%

1%

4%

1%

0% 20% 40% 60% 80% 100%

Fast symptom relief

Long lasting relief

Complete symptomrelief

Easy to take

Few side effects

Low cost

Not sureMost Next

36

Discomfort During Allergy Attack

Q8. In general, would you say that patients’ discomfort during a nasal allergy attack is usually something they can ignore, they can’t ignore it, but they can tolerate it, or they can’t tolerate it without relief? N=400

PQ17. In general, when you have a nasal allergy attack would you say that your discomfort is usually something you can ignore, you can’t ignore it, but you can tolerate it, or you can’t tolerate it without relief? N=2,500

45%

60%

44%

45%

44%

33%

51%

58%

55%

55%

38%

55%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary care

Nurse Prac./PhysicianAsst.

Patients who have seendoctor

Patients who have notseen doctor

Can't tolerate Can't ignore

37

Productivity when Nasal Allergies are at Their Worst

Q10. Thinking about productivity at work on a scale from 0 to 100, where 100 means 100% productivity, where would you rank the productivity of persons with allergic rhinitis, when their nasal allergies are at their worst? N=400

PQ25. Where would you rank your productivity on the same scale of 0 to 100 … when your nasal allergies are at their worst? Base: Employed full time N=1,315

Mean

69%

75%

62%

64%

60%

65%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary Care

Nurse Prac./PhysicianAsst

Patients who have seendoctor

Patients who have notseen doctor

38

Percent of Patients Very Satisfied With Disease Management

Q20. Approximately, what proportion of your patients with nasal allergies would you say are VERY satisfied with the management of their disease? Would you say… N=400

PQ51. Overall, how satisfied are you with your health practitioner’s management and treatment of your nasal allergies? N=2,500

78%

87%

62%

58%

56%

3%

4%

3%

72%

8%

31%

17%

28%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary care

Nurse Prac./PhysicianAsst.

Patients who have seendoctor

Patients who have notseen doctor

All (91% to 100%) Most (51% to 90%) Some (11% to 50%)

39

Satisfaction of Patients with Intra-nasal Corticosteroids

Q36. In general, how satisfied are your allergic rhinitis patients with their intra-nasal corticosteroids? Would you say that they are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied? N=400

PQ70b. In general, how satisfied have you been with the prescription nasal spray you have used for your nasal allergies in the past? Base: Ever used Rx nasal spray for nasal allergies N=2,033

33%

54%

61%

55%

39%

37%34%

41%

41%

39%

42%

57%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary care

Nurse Prac./PhysicianAsst.

Patients who have seendoctor

Patients who have notseen doctor

Very satisfied Somewhat satisfied

40

Patients Get Monies Worth from Rx Medicines

Q30. Overall, do your patients feel they get their money’s worth out of prescription medicines for nasal allergies? N=400PQ97. Overall, do you feel that patients get their money’s worth out of prescription medicines for nasal allergies?

N=2,500

55%

87%91%

85%82%

0%

20%

40%

60%

80%

100%

ENT Allergist Primary care NursePrac./Physician

Asst.

All Patients

41

Opinions About Nasal Allergies

Q44. Now I am going to read you a series of statements. As I read each statement, please tell me whether you agree strongly, agree somewhat, disagree somewhat or disagree strongly with the statement. N=400

PQ110. Now I am going to read you a series of statements. As I read each statement , please tell me whether you agree strongly, agree somewhat, disagree somewhat or disagree strongly with the statement N=2,500

Agree Strongly

82%

71%

25%

49%

78%

77%

35%

30%

1%

38%

70%

55%

44%

24%

1%

45%

73%

58%

55%

28%

15%

22%

56%

64%

79%

58%

2%

40%

59%

3%

0% 20% 40% 60% 80% 100%

Nasal allergies are a serioushealth problem in the US

Even with proper treatmentnasal allergies usually cause

some lifestyle limitations

There are no truly effectivetreatments for nasal allergies

Frequent nasal allergysymptoms can be prevented

in most cases

Nasal allergies can makeasthma worse

Nasal allergies can causesinus infections

ENT Allergist Primary care Nurse Prac./Physician Asst. Patients

42

Need for Better Education of Patients

Q45. How much need do you think there is for better education of PEOPLE WITH NASAL ALLERGIES about their condition and its treatment? Do you think there is a… N=400

PQ113. How much need do you think there is for better education of people with nasal allergies about their condition and its treatment? N=2,500

57%

61%

57%

49%

38%

37%

43%

43%

40%

52%

0% 20% 40% 60% 80% 100%

ENT

Allergist

Primary care

Nurse Prac./PhysicianAsst.

All Patients

Strong need Moderate need

43

Aware of Professional Guidelines

Q46a. Are you aware of any professional guidelines for the diagnosis and management of allergic rhinitis? N=400

Yes

64%

46%

88%

62%

0%

20%

40%

60%

80%

100%

ENT Allergist Primary care Nurse Prac./PhysicianAsst.

44

Publisher of Guidelines

Q46b. Who publishes those guidelines? Base: Aware of Guidelines N=260

15%

13%

3%

2%

57%

40%

2%

7%

11%

4%

28%

20%

9%

33%

13%

3%

3%

11%

13%

5%

22%

39%

3%

2%

56%

21%

16%

16%

22%

0% 20% 40% 60% 80% 100%

Other medical society

AAOA

Joint task force

AAAAI

ACAAI

Medical journal

Other

Don't know

Nurse Prac./Physician Asst.

Primary care

Allergist

ENT