The cost of the common cold

Cough and cold products are displayed on a shelf at a pharmacy in the Brooklyn borough of New York City.

TEXT OF INTERVIEW

Tess Vigeland: How are you feeling today? Got the sniffles? Sore throat, maybe? It's that time of year when you probably know at least one person who's dealing with a cold. And they're spending a lot of money on it. Exactly how much? Close to $40 billion, according to researchers. We asked a few of our colleagues here at Marketplace how much they usually spend to quash the common cold.

MARKETPLACE STAFF: My kids go through a lot of the Children's Motrin, so we've probably purchased three or four bottles this season. It's about $8 a pop. But I definitely do buy those Vitamin C drops. I eat those like candy and those are about $4. I got that Vitamin C powder and then I also got Alka-Seltzer Plus Cold Medicine, so maybe between $21 and $30. Vitamin C stuff, Vitamin D, something called Wellness Formula and I probably spend about $60 a month.

All right, so we wondered what the real impact is of the common cold, especially when it comes to our wallets. Dr. Mark Fendrick of the University of Michigan looked into that price tag and joins us. Welcome.

FENDRICK: Thanks for having me.

VIGELAND: So what is the kind of per-person, per-cold price tag? Do you have a rough estimate?

FENDRICK: Well, as you know, costs of cold are variable depending on if it's a very quick, self-limited condition or that it actually leads to things like a visit to the drugstore to get an over-the-counter medication, or going to the doctor, which then leads to things like prescription drugs, X-rays. And those rare instances when you actually need to be admitted for a complication, such as pneumonia. When we put the whole pie together, it adds up to an amount more than things like congestive heart failure, osteoporosis, and asthma -- which seem to get a lot more attention.

VIGELAND: Wow.

FENDRICK: That's largely because, as you know, the common cold is the most common disease in man and that nearly three-quarters will have a cold in a year. And if you have one, you may have two. And what is surprising, actually even for me as a practicing primary-care physician, that most people reported that a cold will last about one week long. And maybe even more surprisingly is that up to a quarter said that their symptoms did not go completely away until after 14 days.

VIGELAND: Yeah, that's me. I don't think I've ever had any such thing as a two- or three-day cold. And I have to tell you, I think that so many of us as employees go through something of a cost-analysis ourselves when we get sick, which is if I'm away from work and I don't have decent sick leave, there's kind of a perverse incentive to go to work while you're sick, which means you're probably going to stay sick longer and you're going to infect other people.

FENDRICK: And coming up with our $40 billion number, Tess, we didn't even consider the obvious thing that you just mentioned, that being the transmission potential for the common cold. I think we typically don't measure work-loss issues, even when you have the illness. And in the case of the common cold, most of the work-loss costs were for parents who were taking time off to spend 126 million days a year to stay home with their sick kids.

VIGELAND: Let me ask you about what I find to be one of the biggest expenditures when I'm sick, which is that trip to the drugstore. And I don't think I usually escape that place without spending at least $50. It is really expensive to get sick!

FENDRICK: Right. And people don't even think about the amount of money that's spent for the over-the-counter medications, which in our case were up to $3 billion a year. As you know, you walk into any store, the size of the cough and cold aisle is clearly enormous because there is a medication to treat each and every one of the symptoms of fever, cough, runny nose, headache, etc. And you could get any possible combination of therapies to treat one, two, three, four, and even five symptoms at the exact same time. I will say, though, that when you talk about prescription drugs, the amount of money we spend on upper respiratory tract infections should be lower than it is because, as most people well know, we don't have an effective prevention or curative medication for these viral illnesses. And probably what your grandmother told you -- hydration, rest, maybe some chicken soup, orange juice, etc. -- may be just as good as that $50 visit to the pharmacy window, which you mentioned.

VIGELAND: You know, one question that comes up when I'm sick is: Do I buy the brand name? Do I go for the Nyquil, the Benadryl, the Sudafed, or do I go for the generic that's maybe a few bucks cheaper and appears to have pretty much the same ingredients, according to the box?

FENDRICK: It does, but I'll tell you that being the father of four teenagers, when I try to bring home store-brand Cap'n Crunch, I get an uproar as opposed to the name brand. So I think there's something in addition to those same ingredients to actually what people believe is the effect as opposed to what the ingredients would make up. In most of the single treatments, the generic medication -- that being the active ingredient -- is often the exact same as between the brand and the store-brand agents.

VIGELAND: Dr. Fenderick, what do you do when you get a cold?

FENDRICK: I do what my grandmother told me to do: matzo ball soup and a little extra Vitamin C. And understand that what I learned from this very interesting study that the common cold is not very commonly quick and over. And that it could take a week, and in the case of Tess Vigeland, two weeks is not at all uncommon.

VIGELAND: Dr. Mark Fenderick, thanks so much.

FENDRICK: My pleasure, Tess.

VIGELAND: Dr. Mark Fendrick is a practicing Internist and co-director of the University of Michigan's Center for Value-Based Insurance Design.

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