SOP research: Food-induced allergic reactions cost half a billion annually
VCU School of Pharmacy researchers have calculated that the cost of treating food allergy reactions in the United States each year is between $340 million and $510 million.
Using federal databases, the team documented that each year food allergy reactions cause about 5,600 inpatient admissions, 82,000 emergency department visits, 33,000 outpatient clinic visits and 585,000 office-based physician visits in this country. This use of health care resulted in medical costs of $225 million to $307 million and lost productivity valued at $115 million to $203 million. Children younger than 18 accounted for 60 percent of resources used.
Food allergy is reported to affect 4 percent to 6 percent of children and 1 percent to 2 percent of adults in the United States. Every year, allergic reactions result in visits to physicians, emergency departments and hospitals.
“This is the first study to quantify the medical costs and lost productivity of treating food allergy reactions,” said SOP alumnus Dipen Patel (Ph.D. ’10), who was a graduate student at the time and lead author of the study. “Details about the economic burden of negative events associated with food allergies will aid private and governmental decision makers in formulating public health policies and clinical guidelines. It will also guide future research that seeks to understand the impact of food allergy events in the U.S.“
The researchers recommended that users consider the upper figure of $510 million because of limitations in the federal databases. David Holdford, who headed the research team, said, “Even the $510 million figure likely underestimates the cost of food allergy reactions because they are difficult to diagnose and frequently go unreported.”
Holdford, a School of Pharmacy associate professor, added, “The amount does not take into account some difficult-to-quantify costs such as purchases of epinephrine devices that are never used, out-of-pocket costs to patients including insurance copayments and transportation to health providers, and purchases of special diets and allergen-free foods. The impact of food allergies on social life, career choices, personal relationships and everyday tasks was not measured, either.
“Nevertheless, this is the first and best national estimate of the burden of food allergy reactions.”
Of the approximately one-half billion dollars spent per year, physician office visits – primarily to specialists –accounted for 52.5 percent of costs. The remaining costs were divided between emergency room visits (20 percent), inpatient hospitalizations (11.8 percent), outpatient visits (3.9 percent), ambulance runs (3 percent) and epinephrine devices (8.7 percent).
The $500 million spent on treating food allergy events was less than the cost of treating asthma and other more prevalent chronic conditions. But for individual patients, the cost of treating food allergy reactions was more. The average cost per food allergy emergency room visit was $533 compared with $345 for asthma, while hospitalizations for food allergies cost $4,719 in contrast to asthma admissions of $4,570.
Researchers found some of the findings surprising. “We expected that emergency room visits would account for more costs,” said Holdford. “Other studies have found more total ER visits per year and more incidents of anaphylaxis.
“We were also surprised at the number of physician office visits associated with food allergies. We typically think of food allergies being associated with acute treatment of anaphylaxis, but many of the visits are probably for non-acute events associated with conversations about avoiding allergic reactions, diagnostic testing, food challenges and repeat testing for natural history of food allergy. We would like to understand more about interactions between physicians and food allergic patients in physicians’ offices.”
Finally, the research identified fewer mortalities associated with food anaphylaxis (23 annually) than other research that suggests the death rate is as high as 150 per year. The researchers caution that the federal databases used in this study were not specifically designed to capture mortality rates and are likely to underestimate deaths due to anaphylaxis.
This research was conducted as part of a Patel’s dissertation, which he successfully defended last July. He now works as a health economist/scientist with Pharmerit in Bethesda, Md. Last month, the study findings were published online as an “article in press” and made available for download at the Journal of Allergy and Clinical Immunology Web site. Also on the research team were Ph.D. candidate Eric Edwards and pharmacy professor Norman V. Carroll.
Thanks to David Holdford for providing this research summary.
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