In the health care arena, assessment of a medication's clinical efficacy is no longer enough. It is important to confirm the medication's cost-effectiveness and the improvement in quality of life it provides in relationship to other options in therapy. H1-antagonists are widely used in the treatment of many atopic disorders, especially allergic rhinitis. This review has pointed out cost-effectiveness and quality-of-life studies comparing the different H1-antagonists among themselves, and with other treatments used in allergic rhinitis, such as intranasal corticosteroids and allergen immunotherapy. Cost-effective analyses among H1-antagonists in other allergic diseases, such as atopic dermatitis, urticaria and angioedema, and asthma, are lacking at this time.