Research shows that allergist care reduces health care costs for children with peanut allergies

Allergist care is associated with lower overall health care costs for US children with peanut allergies, a new study shows.

In a study published in Journal of Allergy and Clinical Immunology: In Practice, Lead researcher Matthew Greenhout, MD, professor of pediatric allergy and immunology at the University of Colorado School of Medicine, and his research colleagues found that annual health care costs were significantly higher among children who did not receive care from an allergist for peanut allergy (PA) compared to those with.

“One of the findings of this study is that these data show that for children with peanut allergy, care by an allergy specialist can save money. This is important for payers to be aware of.”

Using data to track costs

In this and previous studies, Greenhaut worked to “put together a story about why it’s important to treat peanut allergy, why the FDA should approve products to treat it, and why insurance companies you have to pay for these products.”

Greenhout and fellow researchers used special diagnosis codes from IBM MarketScan Commercial Claims and Encounters data collected from January 2010 to June 2019 to demographically match 72,854 patients with peanut allergy and 166,825 patients with food allergy, not associated with peanuts (NPAFAC). Outcomes were measured and compared 12 months before and after the first claim date.

Among more than 72,000 people with PA, nearly 54% had one or more visits to an allergist. Those with PA who received care from an allergist compared with those who did not receive the care of an allergist were prescribed epinephrine at significantly higher rates and had higher rates of epinephrine insurance claims, epinephrine cost, and anaphylaxis.

Greenhout and his research colleagues found that total health care costs were higher in the NPAFAC group than in the PA group. Among those with PA, total health care costs were significantly lower in those who received care from an allergist compared to those who did not, $6,347 versus $8,270.

Unforeseen economic consequences

“We were impressed, but not surprised, to see that allergists are dealing with children who have more adrenaline-related complaints,” says Greenhaut. “We believe that this is a sign of greater severity of the disease. But it was interesting to see that even in the peanut allergy group, despite indications that the children had a higher severity of disease, treatment by an allergist still resulted in cost savings compared to those not seeing an allergist.”

Greenhaut emphasizes that health economics and health care utilization related to food allergy diagnosis and reaction treatment are understudied, and he hopes data like this can help demonstrate the high value of allergist care for food allergies, particularly peanut allergy.

“For example, if you look at anaphylaxis, those are very expensive treatments,” Greenhaut says. “And I’m not suggesting that these kinds of admissions don’t happen despite the fact that a person with a peanut allergy is under the care of an allergist. But this study provides evidence that for people with peanut allergyAllergy specialty care is cost-effective compared to not having a specialist, and that provides value to both payers and patients.”

One limitation of the data in this study is that it was not stratified by type of insurance plan, type of deductible, or number of special visits allowed by the plan. However, Greenhout notes that this is an area for further study to better understand how specialized allergy care can be provided.

“We want to make sure that allergists are central to the care of food patients allergy“, – says Greenhaut. “Every year the compensation is reduced and we are given fewer resources to solve the same or more problems. This is research that may provide evidence that payer choices about which services to cover may have unintended economic consequences.”