Care from an allergist is associated with lower total health care costs for American children with peanut allergy, new research shows.
In a study published in the Journal of Allergy and Clinical Immunology: In Practice, lead researcher Matthew Greenhawt, MD, professor of pediatric allergy and immunology at the University of Colorado School of Medicine, and his co-investigators found that annual health care costs were significantly higher in children who did not receive care from an allergist for peanut allergy (PA) compared to those who did.
“One of the findings of this research is that this data shows that for children with peanut allergies, care from an allergy specialist can save money. It is important that payers realize this.
Use data to track costs
In this research and in previous research, Greenhawt endeavored to “build a story about why peanut allergy is important to treat, why the FDA should approve products to treat it, and why insurance companies should pay for these products.
Greenhawt and his co-researchers used specific diagnosis codes from IBM MarketScan Commercial Claims and Encounters data collected between January 2010 and June 2019 to establish a demographic match with a total of 72,854 patients with peanut allergy and 166,825 patients with non-peanut food allergy controls (NPAFAC). Outcomes were measured and compared for 12 months before and after the date of first application.
Of the 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 to those who did not receive care from an allergist were prescribed epinephrine at significantly higher rates, and also had higher rates epinephrine insurance claims, epinephrine costs, and number of peanut anaphylaxis events.
Greenhawt and his co-researchers found that total healthcare costs were higher in the NPAFAC group than in the PA group. Among people with PA, total health care costs were significantly lower among those who received care from an allergist compared to those who did not – $6,347 versus $8,270.
Unintended economic consequences
“We were impressed but not surprised to see that allergists are dealing with children who have more epinephrine-related complaints,” Greenhawt said. “We see this as a mark of higher disease severity. But it was interesting to see that even in the peanut allergy group, despite markers indicating the children had more severe disease, receiving care from an allergist still resulted in cost savings compared to those who did not see an allergist. .
Greenhawt points out that the health economics and utilization of health services related to diagnosing food allergies and treating reactions have been understudied, and he hopes data like this can help demonstrate the great value associated with allergist care for food allergies, particularly peanut allergy. .
“For example, if you look at anaphylaxis, those are very expensive admissions,” says Greenhawt. “And I’m not saying that such admissions don’t occur despite a person with peanut allergy being under the care of an allergist. But this study provides data indicating that for people with peanut allergy, care Allergy specialists save money compared to no specialist, and it brings 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 specialty visits allowed by the plan. However, Greenhawt notes that this is an area for further exploration to better understand how specialist allergy care can be delivered.
“We want to make sure that allergists play a central role in the care of patients with food allergies,” says Greenhawt. “Each year reimbursement reductions occur and we have fewer resources to address the same issue or more. This is a study that can provide evidence that the choices a payer makes about which services to cover can have unintended economic consequences.
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