Fong TA, et al. The economic impact of food allergy. Presented at: EAACI Hybrid Congress; July 1-3, 2022; Prague (hybrid meeting).
Disclosures: The authors report no relevant financial information.
Although the impact varies by country and type, food allergies come with substantial monetary costs to families and other stakeholders, according to the study results.
“While other aspects of food allergy have been widely studied, little research has been conducted to explore the economic burden and impact of food allergies,” Andrew T. Fong, MD, MHLM, pediatric registrar at Westmead Children’s Hospital in Sydney, Australia, said during the presentation at the Hybrid Congress of the European Academy of Allergy and Clinical Immunology.
Based on the PRISMA guidelines for litter exams and with costs converted to euros, the researchers found that the costs of childhood food allergies amounted to 22.8 billion euros per year in the United States, or 3 849 euros per child and per year. However, the carers indicated that they would be ready to pay a maximum of 3,224 euros per year and per child for the management of food allergies.
“Switching from delayed introduction to early introduction of food allergens has been shown to reduce the development of food allergies, and it is cost effective to do so without screening,” Fong said, although he noted that it is not economically viable to screen all infants before introducing them to potential allergens.
In high-risk children, for example, additional costs to prevent a single allergic reaction to peanuts include 18,762 euros for skin tests and 65,338 euros for serum IgE tests. Additionally, the SPT yielded false positives in approximately 3.4% of all identified peanut allergy cases.
“Compared to age- and sex-matched controls, the total incremental costs associated with peanut allergy per person were $400 per year,” Fong said. “It was higher for those with a history of anaphylaxis and those who were prescribed an adrenaline auto-injector.”
When atopy was matched, the total annual additional health costs associated with peanut allergy were 304 euros.
The researchers also found that the cost-effectiveness of cow’s milk protein allergy management strategies differs by health care system. Some countries, the researchers found, found that initial management via an extensively hydrolyzed formula with the probiotic Lactobacillus rhamnoses GG was the most cost-effective strategy.
Adrenaline auto-injectors have a high cost per use, the researchers added, necessitating a balance between cost-effectiveness and adverse effects. When the risks of hospitalization and death are taken into account and universal transport and appropriate use are assumed, Personal Adrenaline has a maximum price based on the value of 45 euros per device.
Patients with a history of anaphylaxis incurred additional costs of 794 euros, while those prescribed an epinephrine auto-injector incurred additional costs of 470 euros.
“Considering school-stocked adrenaline devices may also be a cost-effective strategy,” Fong said, as the researchers also noted that 48% of children at risk for anaphylaxis may not carry self- designated adrenaline injector.
Varying healthcare structures and living costs make it difficult to compare healthcare costs between countries, the researchers wrote. However, they found that 31% of direct costs borne by families in the United States were related to additional food costs.
Additionally, costs for food, travel to appointments, and medication were 8,845 euros for households in Canada with people with food allergies, compared to 7,156 euros for households without people with food allergies. of food allergies.
In Sweden, households allergic to milk had costs of 8,164 euros, those allergic to eggs had costs of 3,961 euros and those allergic to wheat had costs of 4,792 euros.
As for immunotherapy, the researchers said costs must be balanced between immediate benefits such as protection against anaphylaxis and long-term benefits such as prolonged unresponsiveness.
“When evaluating a value-based cost for immunotherapy, the annual cost of treatment could not exceed approximately $1,200, including clinician visits, to be cost-effective,” Fong said.
Although commercial forms of immunotherapy are not yet cost-effective, researchers have found that there is evidence that non-commercial forms are cost-effective while improving quality of life.
Despite differences by country and type of food allergy, the researchers concluded that there is a significant cost pattern for people living with food allergy and for those involved in their treatment.