Virginia Nowakowski, MPH with Dr. Lucy Bilaver, PhD
Assessing Allergies’
COST
If the warming weather has ever made your nose run or your eyes water, you are not alone. Millions of Americans suffer from allergic symptoms like these each year. In many cases, taking a simple antihistamine is enough to clear up any problems, but not all allergies are the same. While spring weather may cause sneezing or a slight rash for individuals with seasonal allergies, eating the wrong meal can send people with peanut allergies into a state of anaphylactic shock.
Regardless of the severity of the allergy, there is no doubt that allergies are widespread in the United States. Between allergic rhinitis, respiratory allergies, skin allergies, and food allergies, more than 50 million Americans suffer from some kind of allergy, and many will deal with this problem their whole lives, making allergies the sixth leading cause of chronic illness [1]. While allergies may seem like an individual’s problem, the prevalence of allergies is actually a major public health concern. Allergies, especially among the 5.6 million children who deal with food allergies, require extensive management in order to protect individuals’ health. That management comes at a cost to both families and society. Northwestern’s Dr. Lucy Bilaver, PhD, was one of the first researchers to quantify the economic burden of children’s food allergies when she worked with a team to examine caregivers’ reports of costs related to allergy care [2]. The researchers’ 2013 analysis provided a clearer look into how families manage allergies as well as how much allergies actually cost.
“We didn't really have an estimate prior to that study of the scope of the economic burden,” Bilaver says. “We found in adding up all these different types of costs that the total economic burden of food allergy was just under $25 billion – spent annually.” The researchers measured costs that would typically be part of managing an allergy, including both direct medical costs to the healthcare system, as well as indirect medical costs that were borne by the family. Most of the direct medical costs included what one might expect in caring for any chronic condition – for one, more visits to the doctor. “A family might initially discuss an allergic reaction or concern of a food allergy with a pediatrician, but usually there is some more specialized testing, such as skin testing, that would happen in a special allergy visit,” Bilaver says. “Usually an allergist would recommend a yearly visit – seeing an allergist on a regular basis would be an important part of standard care.” In addition to regular doctors’ visits, families dealing with allergies may need to consider medications for daily management or for rescue, in cases of accidental exposure to the allergen. Epinephrine auto-injectors are a common, quite expensive treatment individuals keep on hand for occasions when a serious allergic reaction like anaphylaxis develops. However, Bilaver
NPHR 2020 | pg. 23
